Clinical breast cancer最新文献_第5页

Prognostic Value of Tumor-Infiltrating Lymphocytes in Breast Cancer Patients Treated With Radiotherapy: A Systematic Review of Literature 肿瘤浸润淋巴细胞在乳腺癌放疗患者预后中的价值：文献系统综述。

IF 2.5 3区医学 Q2 ONCOLOGY

Clinical breast cancer

Pub Date : 2026-01-01 DOI: 10.1016/j.clbc.2025.07.005

Yasmin A. Civil , Nora D. Purcell , Ralph de Vries , Arlene L. Oei , Victor L.J.L. Thijssen , Tanja D. de Gruijl , Berend J. Slotman , Famke L. Schneiders , H.J.G. Desirée van den Bongard

High tumor-infiltrating lymphocytes (TILs) levels in triple-negative and HER2-positive breast cancer are associated with better survival outcomes, highlighting its potential as prognostic biomarkers. Radiotherapy can also trigger immune cell infiltration. This systematic review evaluates the prognostic value of TILs in radiotherapy-treated breast cancer patients. A literature search (in PubMed, Embase and Web of Science) was performed up to April 5, 2024 (PROSPERO registration CRD42024401741). Two independent reviewers screened articles according to predefined criteria, resolving discrepancies through consensus. The collected outcomes were prognostic value of TILs for ipsilateral breast tumor recurrence (IBTR), any recurrence, distant metastasis (DM), overall survival (OS) and disease-free survival (DFS). Of 10,927 records, 11 studies (3899 patients) were included. Patients underwent lumpectomy or mastectomy, with or without postoperative radiotherapy. Three studies examined neoadjuvant partial breast irradiation. The stroma threshold for high vs. low TILs ranged from 5 to 50%, with most patients (73%) having low TILs. Low TILs patients significantly benefited from radiotherapy in reducing IBTR and any recurrence. In luminal B, triple-negative and HER2-positive subtypes, high TILs were associated with better outcomes in DM, OS and DFS. For radiotherapy-treated luminal A breast cancer, low TILs were associated with improved OS. For DCIS patients, low TILs correlated with reduced IBTR. TILs could be a prognostic biomarker for radiotherapy-treated breast cancer patients. However, study heterogeneity complicates comparisons. To refine personalized treatment, further prospective studies are necessary to investigate TILs levels and the impact of neoadjuvant radiotherapy on oncological outcomes across different breast cancer subtypes.

在三阴性和her2阳性乳腺癌中，高肿瘤浸润淋巴细胞（TILs）水平与更好的生存结果相关，突出了其作为预后生物标志物的潜力。放射治疗也能引发免疫细胞浸润。本系统综述评估TILs在放疗乳腺癌患者中的预后价值。文献检索（PubMed， Embase和Web of Science）进行到2024年4月5日（PROSPERO注册号CRD42024401741）。两名独立审稿人根据预先确定的标准筛选文章，通过共识解决差异。收集的结果是TILs对同侧乳腺肿瘤复发（IBTR）、任何复发、远处转移（DM）、总生存期（OS）和无病生存期（DFS）的预后价值。在10927份记录中，纳入了11项研究（3899例患者）。患者接受乳房肿瘤切除术或乳房切除术，术后有或没有放疗。三项研究考察了新辅助部分乳房放疗。高TILs vs低TILs的间质阈值从5%到50%不等，大多数患者（73%）TILs较低。低TILs患者在减少IBTR和任何复发方面明显受益于放疗。在luminal B、三阴性和her2阳性亚型中，高TILs与DM、OS和DFS的较好预后相关。对于放射治疗的腔A乳腺癌，低TILs与改善的OS相关。对于DCIS患者，低TILs与IBTR降低相关。TILs可能是放疗乳腺癌患者的预后生物标志物。然而，研究异质性使比较复杂化。为了完善个性化治疗，需要进一步的前瞻性研究来调查不同乳腺癌亚型的TILs水平和新辅助放疗对肿瘤预后的影响。

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引用次数: 0

Prognostic Impact of Real-World Immunohistochemical Changes in Breast Cancer Treated with Neoadjuvant Chemotherapy 乳腺癌新辅助化疗后真实世界免疫组织化学变化对预后的影响。

IF 2.5 3区医学 Q2 ONCOLOGY

Clinical breast cancer

Pub Date : 2026-01-01 DOI: 10.1016/j.clbc.2025.07.023

Marcelo Antonini , André Mattar , Marcelo Madeira , Letícia Xavier Félix , Julio Antonio Pereira de Araújo , Francisco Pimentel Cavalcante , Felipe Zerwes , Fabricio Palermo Brenelli , Antonio Luis Frasson , Eduardo Camargo Millen , Marina Diógenes Teixeira , Larissa Chrispim de Oliveira , Marcellus do Nascimento Moreira Ramos , Gil Facina , Rogério Fenile , Henrique Lima Couto , Sabrina Monteiro Rondelo , Leonardo Ribeiro Soares , Ruffo de Freitas Junior , Renata Arakelian , Luiz Henrique Gebrim

Purpose

To evaluate the rate and types of immunohistochemical (IHC) changes after neoadjuvant chemotherapy (NAC) and their influence on disease-free survival (DFS) and overall survival (OS) in breast cancer patients, with a focus on conversions such as HR+/HER-2+ to HR-/HER-2- and their implications for treatment adjustments.

Methods

This retrospective cohort study included 369 female patients aged 18 years or older with nonmetastatic breast cancer treated with NAC between January 2011 and January 2023. Patients who did not achieve complete pathological response were evaluated for changes in IHC profiles, including hormone receptor (HR) status, HER-2 expression, and Ki-67 index. Prognostic outcomes were assessed using Kaplan-Meier survival analysis and multivariate Cox regression models.

Results

IHC changes were observed in 41.7% of patients. Among those initially classified as HR-/HER-2-, 50.9% gained HR expression, and 14.1% acquired HER-2 expression. In HR+/HER-2+ cases, 70.8% experienced a loss of HER-2 expression. Patients with HER-2+ tumors exhibited more frequent IHC changes compared to HER-2- cases (P < .0001). After a median follow-up of 47.7 months, local recurrences occurred in 10.3% of patients, distant metastases in 29.5%, and 25.5% had died. Patients with IHC changes demonstrated significantly worse DFS and OS (P = .002), with the poorest outcomes associated with conversion to HR-/HER-2- (P < .001).

Conclusion

Post-NAC IHC changes are common and associated with poor prognosis, especially in patients losing HR and HER-2 expression. Monitoring IHC shifts is critical for guiding personalized treatment and improving prognostic evaluation.

目的：评估乳腺癌患者新辅助化疗（NAC）后免疫组化（IHC）变化的比率和类型及其对无病生存期（DFS）和总生存期（OS）的影响，重点关注HR+/HER-2+向HR-/HER-2-的转化及其对治疗调整的影响。方法：这项回顾性队列研究纳入了2011年1月至2023年1月期间369名18岁及以上接受NAC治疗的非转移性乳腺癌女性患者。未达到完全病理反应的患者评估IHC谱的变化，包括激素受体（HR）状态、HER-2表达和Ki-67指数。使用Kaplan-Meier生存分析和多变量Cox回归模型评估预后结果。结果：41.7%的患者出现免疫组化改变。在最初分类为HR-/HER-2-的患者中，50.9%获得HR表达，14.1%获得HER-2表达。在HR+/HER-2+病例中，70.8%的患者出现HER-2表达缺失。HER-2阳性肿瘤患者比HER-2阳性肿瘤患者表现出更频繁的免疫组化变化（P < 0.0001）。中位随访47.7个月后，10.3%的患者发生局部复发，29.5%的患者发生远处转移，25.5%的患者死亡。IHC改变的患者表现出更差的DFS和OS (P = 0.002)，与HR-/HER-2-转化相关的最差结果（P < 0.001）。结论：nac后IHC改变很常见，且与预后不良有关，尤其是HR和HER-2表达缺失的患者。监测免疫健康变化对于指导个性化治疗和改善预后评估至关重要。

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引用次数: 0

Preferences for Breast Cancer Survivorship Programs Among Multiracial and Ethnic Women 多种族和民族妇女乳腺癌生存计划的偏好。

IF 2.5 3区医学 Q2 ONCOLOGY

Clinical breast cancer

Pub Date : 2026-01-01 DOI: 10.1016/j.clbc.2025.07.019

Lisa Anderson , Oindrila Bhattacharyya , Akia Clark , Sharnell Smith , Michael Grimm , Elizabeth Fox , Annie Trance , Bridget A. Oppong

Purpose

With advancements in breast cancer treatment, survivorship has increased, leading to 3.8 million survivors in the US. These women have diverse supportive care needs, often addressed through survivorship programs (SPs), which provide clinical and nonclinical support services. SPs aim to deliver a holistic approach to comprehensive breast cancer treatment and recurrence prevention. Historically, disparities in SP utilization exist among minority and elderly women. This study aims to explore trends varying in SP participation by age and race within a single institution.

Methods

A retrospective analysis of breast cancer patients' survivorship needs at a tertiary referral academic cancer center program was conducted. Data were collected from programs between 2019 and 2022, including demographics and referrals to clinical resources such as Adolescent/Young Adult care, Fertility preservation, Palliative care, Psychosocial support, and Survivorship. Participation in nonclinical areas, including Art, Education, Exercise, Mind-Body-Spirit, and Nutrition, was also evaluated. Descriptive statistics summarized patterns based on age, race, and ethnicity.

Results

From 2019 to 2022, 2198 patients attended SPs, with Nutrition and Exercise being the most popular. Most attendees were 60-69 years old and White. Black attendees declined from 9.9% (2019) to 5.7% (2022). Clinical resources showed the highest referral rate to survivorship clinics. Black patients saw an increase in palliative care referrals, rising from 11% to 21%.

Conclusion

Data reveal differences in clinical referrals by age and race, with fewer referrals for older women and more for Black patients. Participation in nonclinical SPs was similar across groups. Future program development will focus on inclusivity and equitable access.

目的：随着乳腺癌治疗的进步，生存率增加，在美国有380万幸存者。这些妇女有不同的支持性护理需求，通常通过提供临床和非临床支持服务的幸存者计划（SPs）来解决。SPs旨在提供一种全面的方法来全面治疗乳腺癌和预防复发。历史上，少数民族妇女和老年妇女在SP利用方面存在差异。本研究旨在探讨在单一机构中，年龄和种族不同的SP参与趋势。方法：回顾性分析三级转诊学术癌症中心项目乳腺癌患者的生存需求。从2019年至2022年的项目中收集数据，包括人口统计数据和转介到临床资源的数据，如青少年/青年护理、生育保护、姑息治疗、社会心理支持和幸存者。参与非临床领域，包括艺术，教育，运动，身心精神和营养，也进行了评估。描述性统计总结了基于年龄、种族和民族的模式。结果：2019年至2022年，共有2198例患者参加了SPs，其中营养和运动最受欢迎。大多数与会者是60-69岁的白人。黑人参会者从2019年的9.9%下降到2022年的5.7%。临床资源显示最高转诊率到生存诊所。黑人患者接受姑息治疗的比例从11%上升到21%。结论：数据显示临床转诊在年龄和种族方面存在差异，老年妇女的转诊较少，黑人患者的转诊较多。非临床SPs的参与在各组之间相似。未来的项目发展将侧重于包容性和公平获取。

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引用次数: 0

Does Epstein–Barr Virus Contribute to Breast Cancer Risk Worldwide? A Systematic Review and Meta-Analysis 爱泼斯坦-巴尔病毒会增加全球乳腺癌风险吗？系统回顾和荟萃分析。

IF 2.5 3区医学 Q2 ONCOLOGY

Clinical breast cancer

Pub Date : 2026-01-01 DOI: 10.1016/j.clbc.2025.07.017

Francisco Cezar Aquino de Moraes , Pedro Henrique de Souza Wagner , Ana Beatriz Nardelli da Silva , Maria Cristina Figueroa Magalhães , Rommel Mario Rodríguez Burbano

Introduction

Breast cancer (BC) is the most common cancer among women worldwide, accounting for over 2.3 million new cases annually. Recent evidence suggests Epstein-Barr virus (EBV) may play a role in its pathogenesis. Given EBV’s known oncogenic potential, this study investigates the prevalence and possible role of EBV in BC pathogenesis.

Methods

Random-effects meta-analyses were conducted to estimate raw proportions and risk ratio (RR), with 95% confidence intervals (CIs). Heterogeneity was assessed using I². Statistical significance was set at P < .05. Analyses were performed in R 4.2.3

Results

Our meta-analysis included 57 studies, comprising a total of 5,133 BC tissues to analyze the presence of EBV. Our analysis revealed a prevalence of 25% (95% CI: 21%-30%) of EBV in BC tissues. In the analysis by continent, Europe, Africa, and Oceania showed a similar proportion of 33%. Regarding the risk of EBV in BC tissues compared to healthy controls, the analysis identified a statistically significant difference, presenting higher risk of EBV in the BC group (RR: 3.35; P < .001). South America showed the highest and significant RR of 12.34 (P = .007) among the continents. Subgroup analysis by income revealed that the low-income-group exhibited the highest EBV prevalence (44%; 95% CI: 28%-61%). According to the subtype BC analysis, triple-negative BC exhibited the highest EBV prevalence (30%; 95% CI: 19%-44%).

Conclusion

This meta-analysis underscores the global prevalence of EBV in BC and highlights a potential association between EBV presence and breast cancer. Further standardized, prospective studies using robust detection methods, including paired tissue analyses, are needed to confirm these observations and to clarify the possible role of EBV in breast tumorigenesis.

乳腺癌（BC）是全世界女性中最常见的癌症，每年有超过230万的新病例。最近的证据表明，eb病毒（EBV）可能在其发病机制中起作用。鉴于EBV已知的致癌潜力，本研究调查了EBV在BC发病机制中的患病率和可能的作用。方法：采用随机效应荟萃分析估计原始比例和风险比（RR）， 95%可信区间（ci）。使用I²评估异质性。差异有统计学意义，P < 0.05。结果：我们的荟萃分析包括57项研究，共5133例BC组织，以分析EBV的存在。我们的分析显示EBV在BC组织中的患病率为25% （95% CI: 21%-30%）。在各大洲的分析中，欧洲、非洲和大洋洲的比例相似，为33%。BC组EBV发生风险与健康对照组比较，差异有统计学意义，BC组EBV发生风险较高（RR: 3.35; P < 0.001）。南美洲的RR最高，为12.34 （P = 0.007）。按收入进行的亚组分析显示，低收入组EBV患病率最高（44%;95% CI: 28%-61%）。根据BC亚型分析，三阴性BC表现出最高的EBV患病率（30%;95% CI: 19%-44%）。结论：该荟萃分析强调了EBV在BC中的全球患病率，并强调了EBV存在与乳腺癌之间的潜在关联。需要进一步标准化的前瞻性研究，使用强大的检测方法，包括配对组织分析，来证实这些观察结果，并澄清EBV在乳腺肿瘤发生中的可能作用。

{"title":"Does Epstein–Barr Virus Contribute to Breast Cancer Risk Worldwide? A Systematic Review and Meta-Analysis","authors":"Francisco Cezar Aquino de Moraes , Pedro Henrique de Souza Wagner , Ana Beatriz Nardelli da Silva , Maria Cristina Figueroa Magalhães , Rommel Mario Rodríguez Burbano","doi":"10.1016/j.clbc.2025.07.017","DOIUrl":"10.1016/j.clbc.2025.07.017","url":null,"abstract":"<div><h3>Introduction</h3><div>Breast cancer (BC) is the most common cancer among women worldwide, accounting for over 2.3 million new cases annually. Recent evidence suggests Epstein-Barr virus (EBV) may play a role in its pathogenesis. Given EBV’s known oncogenic potential, this study investigates the prevalence and possible role of EBV in BC pathogenesis.</div></div><div><h3>Methods</h3><div>Random-effects meta-analyses were conducted to estimate raw proportions and risk ratio (RR), with 95% confidence intervals (CIs). Heterogeneity was assessed using I². Statistical significance was set at <em>P</em> < .05. Analyses were performed in R 4.2.3</div></div><div><h3>Results</h3><div>Our meta-analysis included 57 studies, comprising a total of 5,133 BC tissues to analyze the presence of EBV. Our analysis revealed a prevalence of 25% (95% CI: 21%-30%) of EBV in BC tissues. In the analysis by continent, Europe, Africa, and Oceania showed a similar proportion of 33%. Regarding the risk of EBV in BC tissues compared to healthy controls, the analysis identified a statistically significant difference, presenting higher risk of EBV in the BC group (RR: 3.35; <em>P</em> < .001). South America showed the highest and significant RR of 12.34 (<em>P</em> = .007) among the continents. Subgroup analysis by income revealed that the low-income-group exhibited the highest EBV prevalence (44%; 95% CI: 28%-61%). According to the subtype BC analysis, triple-negative BC exhibited the highest EBV prevalence (30%; 95% CI: 19%-44%).</div></div><div><h3>Conclusion</h3><div>This meta-analysis underscores the global prevalence of EBV in BC and highlights a potential association between EBV presence and breast cancer. Further standardized, prospective studies using robust detection methods, including paired tissue analyses, are needed to confirm these observations and to clarify the possible role of EBV in breast tumorigenesis.</div></div>","PeriodicalId":10197,"journal":{"name":"Clinical breast cancer","volume":"26 1","pages":"Pages 229-246.e22"},"PeriodicalIF":2.5,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144944992","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

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

IF 2.5 3区医学 Q2 ONCOLOGY

Clinical breast cancer

Pub Date : 2026-01-01 DOI: 10.1016/j.clbc.2025.08.008

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

Aim

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

Methods

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

Results

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

Conclusion

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

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

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引用次数: 0

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

IF 2.5 3区医学 Q2 ONCOLOGY

Clinical breast cancer

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

Mohammed Dlshad Mohsin , Abbas Salihi

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

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

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引用次数: 0

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

IF 2.5 3区医学 Q2 ONCOLOGY

Clinical breast cancer

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

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

Introduction

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

Methods

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

Results

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

Conclusion

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

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

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引用次数: 0

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

IF 2.5 3区医学 Q2 ONCOLOGY

Clinical breast cancer

Pub Date : 2026-01-01 DOI: 10.1016/j.clbc.2025.07.006

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

Aim

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

Methods

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

Results

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

κ

= 0.057 for WBI patients and

κ

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

Conclusions

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

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

{"title":"Physician and Software Assessed Cosmetic Outcomes Following Whole Breast or Partial Breast Radiation Therapy for Breast Cancer","authors":"Anna Okabe , Wai Lone J. Ho , May Lin Tao , Jason C. Ye","doi":"10.1016/j.clbc.2025.07.006","DOIUrl":"10.1016/j.clbc.2025.07.006","url":null,"abstract":"<div><h3>Aim</h3><div>This study aims to compare the cosmetic outcomes in early-stage breast cancer patients treated with whole breast irradiation (WBI) or partial-breast irradiation (PBI), using both subjective and objective tools, to assess clinical factors contributing to cosmesis scores, and to compare radiation toxicity outcomes.</div></div><div><h3>Methods</h3><div>Breast cosmesis was scored by using the physician-rated Harvard cosmesis scale at the time of consultation and at each follow-up visit and objectively using the BCCT.core software on standardized photographs.</div></div><div><h3>Results</h3><div>Ninety-nine patients received WBI, and thirty-six received PBI. 91% of patients treated with WBI and 86.1% with PBI scored excellent/good by physician ratings at follow-up vs. 68.4% and 72.2 % by BCCT.core software. Agreement between both tools was low (<span><math><mi>κ</mi></math></span> = 0.057 for WBI patients and <span><math><mi>κ</mi></math></span> = 0.012 for PBI patients). There was less than a 15% decline in physician-rated cosmetic scores for either WBI or PBI patients, but a 27.3% decline for WBI patients by BCCT.core software scoring. There was no association of prone vs. supine position, tumor bed boost, fractionation scheme, or addition of regional nodal irradiation with long-term cosmesis scores determined by either assessment tool, except for oncoplastic surgery which was associated with a higher score.</div></div><div><h3>Conclusions</h3><div>Breast cosmesis scores after either WBI or PBI are favorable; however, the agreement between physician rating and the BCCT.core software is poor. The BCCT.core software was more likely to indicate a decline in cosmetic results over time. Surgical outcomes may be the most impactful clinical factor in predicting long-term breast cosmesis.</div></div>","PeriodicalId":10197,"journal":{"name":"Clinical breast cancer","volume":"26 1","pages":"Pages 157-164"},"PeriodicalIF":2.5,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144764647","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

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

IF 2.5 3区医学 Q2 ONCOLOGY

Clinical breast cancer

Pub Date : 2026-01-01 DOI: 10.1016/j.clbc.2025.07.016

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

Objective

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

Methods

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

Results

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

Conclusions

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

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

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引用次数: 0

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

IF 2.5 3区医学 Q2 ONCOLOGY

Clinical breast cancer

Pub Date : 2026-01-01 DOI: 10.1016/j.clbc.2025.08.002

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

Objective

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

Methods

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

Results

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

Conclusion

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

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

{"title":"Trajectory of Chemotherapy-Induced Peripheral Neuropathy and Its Predictive Factors in Breast Cancer Patients: A Prospective Longitudinal Study","authors":"Huiqian Xu , Hong Li , Yijing Fan , Shufang Zhang , Yang Wang , Yiying Wang , Lizhi Zhou , Jinghua Zhang","doi":"10.1016/j.clbc.2025.08.002","DOIUrl":"10.1016/j.clbc.2025.08.002","url":null,"abstract":"<div><h3>Objective</h3><div>To explore the trajectory patterns and influencing factors of chemotherapy-induced peripheral neuropathy (CIPN) in breast cancer patients using latent class growth analysis (LCGA).</div></div><div><h3>Methods</h3><div>This study was conducted from September 2022 to September 2023 at a tertiary hospital in Tangshan, China. A total of 350 hospitalized breast cancer patients undergoing chemotherapy were recruited. Data were collected through questionnaires, including general demographic information, disease-related characteristics, lifestyle factors, and psychological status. CIPN was assessed at 5 time points: baseline (T0) and the 21st day after the completion of the 1st (T1), 2nd (T2), 3rd (T3), and 4th (T4) chemotherapy cycles. Latent class growth models (LCGMs) were used to identify distinct trajectory patterns. Univariate analysis and multinomial logistic regression models were applied to examine the influencing factors.</div></div><div><h3>Results</h3><div>Three distinct CIPN trajectory groups were identified: the low-risk stable group (42.3%, n = 148), the moderate-risk progressive group (41.4%, n = 145), and the high-risk rapidly progressing group (16.3%, n = 57). Compared with the low-risk stable group, the predictive factors for the moderate-risk progressive group included body mass index (BMI), hypertension, and depression. For the high-risk rapidly progressing group, predictive factors included BMI, physical activity, social support, hypertension, vitamin D levels, nutritional status, and depression.</div></div><div><h3>Conclusion</h3><div>This study elucidates the heterogeneous trajectory patterns of chemotherapy-induced peripheral neuropathy (CIPN) in breast cancer patients and identifies key influencing factors. Recognizing these characteristics in clinical practice may facilitate the early identification of high-risk patients and enable timely interventions to mitigate CIPN severity.</div></div>","PeriodicalId":10197,"journal":{"name":"Clinical breast cancer","volume":"26 1","pages":"Pages 306-314"},"PeriodicalIF":2.5,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144990969","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0