Pub Date : 2026-02-14DOI: 10.1016/j.clbc.2026.02.002
Karny Ilan, Jollanar Mostafa, Renata Faermann Weidenfeld, David Samoocha, Shani Klein, Gal Yanuka, Tehillah Menes, Miri Sklair-Levy
Introduction and objectives: Early detection remains critical for reducing breast-cancer mortality, yet millions of women worldwide, particularly those in low-resource, rural, or underserved communities, face significant barriers to screening. Clinic-based imaging modalities such as mammography, ultrasound, and MRI require specialized infrastructure, trained personnel, and in-person attendance, contributing to persistent underscreening and sometimes late-stage diagnoses. Feminai is a disposable, wearable self-breast-examination patch that integrates heat, blood flow, tissue conductivity, and density sensing, with AI-driven analysis. This study evaluates the device's accuracy in identifying abnormal breast findings.
Methods: This prospective, noninterventional validation study enrolled 150 women aged 25 to 75 undergoing breast-cancer screening at the "Merav" Clinic, Tel Hashomer Hospital. Participants completed a medical questionnaire and underwent a 5-minute scan using the Feminai wearable patch. All participants underwent standard imaging with mammography, with diagnostic ultrasound or MRI as indicated. Sensor-derived heat and tissue conductivity data were analyzed using a proprietary AI algorithm and compared against radiological assessments and biopsy results.
Results: Among 150 women (mean age 49 years), screening mammography identified 75 as BI-RADS 1 to 2, and 75 as BI-RADS 4 to 5. The Feminai device identified 70 of 75 BI-RADS 4 to 5 cases as suspicious, correctly detecting all biopsy-proven malignant lesions and five benign cases as nonsuspicious, corresponding to 96% sensitivity, 82% specificity, and 98% negative predictive value.
Conclusion: The Feminai Breast Examination Kit showed high accuracy, particularly in sensitivity and NPV, indicating strong potential as a remote, cost-effective, and user-friendly early-detection tool. By enabling self-administered screening without reliance on specialized facilities, Feminai offers a scalable pathway to improve access in rural settings, low-resource communities, and medically underserved populations, groups most vulnerable to delayed diagnosis. Further large-scale validation is warranted, but these findings support its promise as an impactful addition to global breast-cancer screening strategies.
{"title":"Identification of Breast Abnormalities Using Feminai-Breast Examination Patch: A Feasibility Study.","authors":"Karny Ilan, Jollanar Mostafa, Renata Faermann Weidenfeld, David Samoocha, Shani Klein, Gal Yanuka, Tehillah Menes, Miri Sklair-Levy","doi":"10.1016/j.clbc.2026.02.002","DOIUrl":"https://doi.org/10.1016/j.clbc.2026.02.002","url":null,"abstract":"<p><strong>Introduction and objectives: </strong>Early detection remains critical for reducing breast-cancer mortality, yet millions of women worldwide, particularly those in low-resource, rural, or underserved communities, face significant barriers to screening. Clinic-based imaging modalities such as mammography, ultrasound, and MRI require specialized infrastructure, trained personnel, and in-person attendance, contributing to persistent underscreening and sometimes late-stage diagnoses. Feminai is a disposable, wearable self-breast-examination patch that integrates heat, blood flow, tissue conductivity, and density sensing, with AI-driven analysis. This study evaluates the device's accuracy in identifying abnormal breast findings.</p><p><strong>Methods: </strong>This prospective, noninterventional validation study enrolled 150 women aged 25 to 75 undergoing breast-cancer screening at the \"Merav\" Clinic, Tel Hashomer Hospital. Participants completed a medical questionnaire and underwent a 5-minute scan using the Feminai wearable patch. All participants underwent standard imaging with mammography, with diagnostic ultrasound or MRI as indicated. Sensor-derived heat and tissue conductivity data were analyzed using a proprietary AI algorithm and compared against radiological assessments and biopsy results.</p><p><strong>Results: </strong>Among 150 women (mean age 49 years), screening mammography identified 75 as BI-RADS 1 to 2, and 75 as BI-RADS 4 to 5. The Feminai device identified 70 of 75 BI-RADS 4 to 5 cases as suspicious, correctly detecting all biopsy-proven malignant lesions and five benign cases as nonsuspicious, corresponding to 96% sensitivity, 82% specificity, and 98% negative predictive value.</p><p><strong>Conclusion: </strong>The Feminai Breast Examination Kit showed high accuracy, particularly in sensitivity and NPV, indicating strong potential as a remote, cost-effective, and user-friendly early-detection tool. By enabling self-administered screening without reliance on specialized facilities, Feminai offers a scalable pathway to improve access in rural settings, low-resource communities, and medically underserved populations, groups most vulnerable to delayed diagnosis. Further large-scale validation is warranted, but these findings support its promise as an impactful addition to global breast-cancer screening strategies.</p>","PeriodicalId":10197,"journal":{"name":"Clinical breast cancer","volume":"26 4","pages":"51-57"},"PeriodicalIF":2.5,"publicationDate":"2026-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147490681","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 : 2026-02-01Epub Date: 2025-09-25DOI: 10.1016/j.clbc.2025.09.015
Gustavo Nader Marta , Allan Andresson Lima Pereira , Carlos Henrique Dos Anjos , Rudinei Diogo Marques Linck , Daniel de Araujo Brito Buttros , Lincon Jo Mori , Samir Abdallah Hanna , André Guimarães Gouveia , Fabio Ynoe de Moraes
Purpose/Objective
To compare demographic characteristics, stage at diagnosis, treatment patterns, and survival outcomes of breast cancer patients treated in Brazil's public and private healthcare systems.
Materials and methods
This retrospective cohort study analyzed data from the Fundação Oncocentro de São Paulo, including women diagnosed with invasive breast cancer between January 2000 and June 2020. Overall survival (OS) was estimated using Kaplan-Meier methods and log-rank tests. Prognostic factors were evaluated using Cox proportional hazards models.
Results
A total of 65,543 patients were included. Age distribution was similar between the public and private sectors. However, early-stage diagnoses (stages I and II) were significantly more frequent in the private sector (77.8%), whereas the public system had a higher proportion of patients diagnosed at advanced stages (67.8% in stages II and III) and with metastatic disease (11.1% vs. 5.3%). The proportion of patients receiving surgery and at least 2 adjuvant therapies (trimodal therapy) was comparable between sectors (46.6% private vs. 46.2% public). Survival analysis demonstrated consistently higher 5- and 10-year OS across all stages in the private sector. Ten-year OS by stage was: I–81.6% (private) versus 77.5% (public), P < .001; II–74.0% vs. 63.3%, P < .001; III–55.6% versus 39.6%, P < .001; IV–7.6% versus 6.4%, P = .306. Multivariate analysis identified treatment in the private sector, younger age at diagnosis, higher education level, receipt of trimodal therapy, and earlier stage as independent predictors of improved OS.
Conclusion
Breast cancer patients treated in the public healthcare system in Brazil more often present with advanced disease, which is associated with inferior survival outcomes.
目的/目的：比较巴西公立和私立医疗保健系统中乳腺癌患者的人口学特征、诊断阶段、治疗模式和生存结果。材料和方法：这项回顾性队列研究分析了来自圣保罗肿瘤中心基金会的数据，包括2000年1月至2020年6月期间诊断为浸润性乳腺癌的妇女。使用Kaplan-Meier方法和log-rank检验估计总生存期（OS）。采用Cox比例风险模型评估预后因素。结果：共纳入65,543例患者。公共部门和私营部门的年龄分布相似。然而，私营部门的早期诊断（I期和II期）明显更频繁（77.8%），而公共系统的晚期诊断患者比例更高（II期和III期67.8%）和转移性疾病（11.1%对5.3%）。接受手术和至少2种辅助治疗（三联疗法）的患者比例在不同部门之间具有可比性（私立医院46.6%对公立医院46.2%）。生存分析表明，在私营部门的所有阶段，5年和10年的总生存期始终较高。10年分期OS为：I-81.6%（私人）vs . 77.5%（公共），P < .001；II-74.0% vs. 63.3%, P < 0.001；iii: 55.6% vs 39.6%, P < 0.001；IV-7.6%对6.4%,P = .306。多变量分析发现，在私营部门接受治疗、诊断时年龄更小、受教育程度更高、接受三模式治疗和早期阶段是改善OS的独立预测因素。结论：在巴西公共医疗保健系统中接受治疗的乳腺癌患者往往出现晚期疾病，这与较差的生存结果相关。
{"title":"Healthcare-Related Determinants of Breast Cancer Prognosis in São Paulo, Brazil: A Population-Based Cohort","authors":"Gustavo Nader Marta , Allan Andresson Lima Pereira , Carlos Henrique Dos Anjos , Rudinei Diogo Marques Linck , Daniel de Araujo Brito Buttros , Lincon Jo Mori , Samir Abdallah Hanna , André Guimarães Gouveia , Fabio Ynoe de Moraes","doi":"10.1016/j.clbc.2025.09.015","DOIUrl":"10.1016/j.clbc.2025.09.015","url":null,"abstract":"<div><h3>Purpose/Objective</h3><div>To compare demographic characteristics, stage at diagnosis, treatment patterns, and survival outcomes of breast cancer patients treated in Brazil's public and private healthcare systems.</div></div><div><h3>Materials and methods</h3><div>This retrospective cohort study analyzed data from the Fundação Oncocentro de São Paulo, including women diagnosed with invasive breast cancer between January 2000 and June 2020. Overall survival (OS) was estimated using Kaplan-Meier methods and log-rank tests. Prognostic factors were evaluated using Cox proportional hazards models.</div></div><div><h3>Results</h3><div>A total of 65,543 patients were included. Age distribution was similar between the public and private sectors. However, early-stage diagnoses (stages I and II) were significantly more frequent in the private sector (77.8%), whereas the public system had a higher proportion of patients diagnosed at advanced stages (67.8% in stages II and III) and with metastatic disease (11.1% vs. 5.3%). The proportion of patients receiving surgery and at least 2 adjuvant therapies (trimodal therapy) was comparable between sectors (46.6% private vs. 46.2% public). Survival analysis demonstrated consistently higher 5- and 10-year OS across all stages in the private sector. Ten-year OS by stage was: I–81.6% (private) versus 77.5% (public), <em>P</em> < .001; II–74.0% vs. 63.3%, <em>P</em> < .001; III–55.6% versus 39.6%, <em>P</em> < .001; IV–7.6% versus 6.4%, <em>P</em> = .306. Multivariate analysis identified treatment in the private sector, younger age at diagnosis, higher education level, receipt of trimodal therapy, and earlier stage as independent predictors of improved OS.</div></div><div><h3>Conclusion</h3><div>Breast cancer patients treated in the public healthcare system in Brazil more often present with advanced disease, which is associated with inferior survival outcomes.</div></div>","PeriodicalId":10197,"journal":{"name":"Clinical breast cancer","volume":"26 2","pages":"Pages 281-286"},"PeriodicalIF":2.5,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145328503","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 : 2026-02-01Epub Date: 2025-09-17DOI: 10.1016/j.clbc.2025.09.004
Xin Ou , Feng Shi , Yanjie Zhao , Quan Zhou , Keyu Yuan , Shuzhen Lyu , Jiangping Wu , Yanping Li , Qingkun Song
Background
The CD155-CD226/CD96/TIGIT axis, a novel immune checkpoint, showed aberrant expression in breast cancer (BC) and associated with prognosis. This study developed and validated a prognostic model combining these molecules with clinical factors to create a visual tool for individualized BC prognosis.
Methods
Immunohistochemistry assessed CD155, CD226, CD96, and TIGIT expression in the tumor microenvironment (TME). A prognostic index (PI) was constructed based on the expression profiles of these 4 molecules, and survival prediction models incorporating the PI and clinicopathological factors were developed using multivariate Cox regression analysis. Model performance and clinical utility were assessed via the C-index, receiver operating characteristic (ROC) curves, Brier score, calibration plots, and decision curve analysis (DCA). Internal validation of model was conducted using 1000-bootstrap resampling.
Results
The PI stratified patients into high/low-risk groups with distinct survival outcomes. Nomograms incorporating the PI and clinical factors demonstrated robust performance. The C-index was 0.772 (bootstrapped corrected: 0.785) for disease-free survival (DFS) and 0.822 (bootstrapped corrected: 0.824) for overall survival (OS). Time-dependent areas under the ROC curve were ≥ 0.80 for 3-, 5-, and 8-year DFS prediction and ≥ 0.85 for OS prediction. Calibration plots showed excellent agreement between predicted and observed survival outcomes, and DCA confirmed the clinical net benefit of the model. Sensitivity analyses also further validated model robustness.
Conclusions
This study established a novel prognostic tool for BC by combining TME markers with clinicopathological factors. The developed nomograms enabled accurate individualized risk stratification and demonstrated clinical utility, offering a framework for precision oncology to survival prediction.
{"title":"Novel Multi-Biomarker Nomogram Combining CD155/CD226/TIGIT/CD96 Immune Checkpoint Axis for Postoperative Survival Prediction in Breast Cancer","authors":"Xin Ou , Feng Shi , Yanjie Zhao , Quan Zhou , Keyu Yuan , Shuzhen Lyu , Jiangping Wu , Yanping Li , Qingkun Song","doi":"10.1016/j.clbc.2025.09.004","DOIUrl":"10.1016/j.clbc.2025.09.004","url":null,"abstract":"<div><h3>Background</h3><div>The CD155-CD226/CD96/TIGIT axis, a novel immune checkpoint, showed aberrant expression in breast cancer (BC) and associated with prognosis. This study developed and validated a prognostic model combining these molecules with clinical factors to create a visual tool for individualized BC prognosis.</div></div><div><h3>Methods</h3><div>Immunohistochemistry assessed CD155, CD226, CD96, and TIGIT expression in the tumor microenvironment (TME). A prognostic index (PI) was constructed based on the expression profiles of these 4 molecules, and survival prediction models incorporating the PI and clinicopathological factors were developed using multivariate Cox regression analysis. Model performance and clinical utility were assessed via the C-index, receiver operating characteristic (ROC) curves, Brier score, calibration plots, and decision curve analysis (DCA). Internal validation of model was conducted using 1000-bootstrap resampling.</div></div><div><h3>Results</h3><div>The PI stratified patients into high/low-risk groups with distinct survival outcomes. Nomograms incorporating the PI and clinical factors demonstrated robust performance. The C-index was 0.772 (bootstrapped corrected: 0.785) for disease-free survival (DFS) and 0.822 (bootstrapped corrected: 0.824) for overall survival (OS). Time-dependent areas under the ROC curve were ≥ 0.80 for 3-, 5-, and 8-year DFS prediction and ≥ 0.85 for OS prediction. Calibration plots showed excellent agreement between predicted and observed survival outcomes, and DCA confirmed the clinical net benefit of the model. Sensitivity analyses also further validated model robustness.</div></div><div><h3>Conclusions</h3><div>This study established a novel prognostic tool for BC by combining TME markers with clinicopathological factors. The developed nomograms enabled accurate individualized risk stratification and demonstrated clinical utility, offering a framework for precision oncology to survival prediction.</div></div>","PeriodicalId":10197,"journal":{"name":"Clinical breast cancer","volume":"26 2","pages":"Pages 238-247.e3"},"PeriodicalIF":2.5,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145273941","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 : 2026-02-01Epub 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":"2026-02-01","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 : 2026-02-01Epub Date: 2025-09-19DOI: 10.1016/j.clbc.2025.09.006
Shinyoung Lee , Hyehyun Jeong , Eunju Shin , Sae Byul Lee , Jae Ho Jeong , Hee Jin Lee , Gyungyub Gong , Min-Ju Kim , Hee Jeong Kim , Jong Won Lee , Byung-Ho Son , Jaewon Hyung , Jin-Hee Ahn , Kyung Hae Jung , Sung-Bae Kim
Background
In early triple-negative breast cancer (TNBC), surgery following neoadjuvant chemotherapy (NAC) is standard. Adjuvant capecitabine has shown survival benefits in patients with residual disease; however, data remain limited regarding the subgroups that benefit most, particularly when stratified by residual cancer burden (RCB), a key prognostic indicator post-NAC.
Methods
Patients with early TNBC and residual disease following NAC (Feb 2008-Dec 2021) were retrospectively included. After propensity score matching to balance baseline characteristics, recurrence-free survival (RFS) was compared between patients who received adjuvant capecitabine and those who did not.
Results
Of 828 eligible patients, 631 were included in the final propensity score matched analysis (222 capecitabine; 409 observation). Median ages were 48 years (range, 40-56) and 50 years (range, 41-56) in the observation and capecitabine groups. RCB distribution was comparable between groups: RCB-I (10% vs. 11%), RCB-II (68% in both), and RCB-III (22% vs. 21%). RCB was prognostic across the cohort, with 3-year RFS rates of 92.2%, 73.6%, and 43.3% for RCB-I, -II, and -III, respectively. Adjuvant capecitabine improved RFS in RCB-III (HR, 0.6; 95% CI, 0.3-0.9; P = .02), but not in RCB-I (HR, 1.1; 95% CI, 0.2-6.5; P = .93) or RCB-II (HR, 0.9; 95% CI, 0.7-1.4; P = .84). In RCB-III, distant metastasis occurred less frequently in the capecitabine group compared with the observation group (34.0% vs. 62.9%).
Conclusion
Adjuvant capecitabine was most beneficial in patients with RCB-III disease, primarily through a reduction in distant metastasis. These findings support its selective use in high-risk TNBC populations.
背景：在早期三阴性乳腺癌（TNBC）中，手术后新辅助化疗（NAC）是标准的。辅助卡培他滨在残余疾病患者中显示出生存益处；然而，关于受益最大的亚组的数据仍然有限，特别是根据残留癌症负担（RCB）分层时，RCB是nac后的关键预后指标。方法：回顾性研究了2008年2月至2021年12月期间患有早期TNBC和NAC后残留疾病的患者。在倾向评分匹配平衡基线特征后，比较接受辅助卡培他滨和未接受辅助卡培他滨的患者的无复发生存（RFS）。结果：在828例符合条件的患者中，631例纳入最终倾向评分匹配分析（222例卡培他滨；409例观察）。观察组和卡培他滨组的中位年龄分别为48岁（40-56岁）和50岁（41-56岁）。RCB分布在两组间具有可比性：RCB- i（10%对11%）、RCB- ii（两者均为68%）和RCB- iii（22%对21%）。RCB是整个队列的预后指标，RCB- i、-II和-III的3年RFS率分别为92.2%、73.6%和43.3%。辅助卡培他滨改善RCB-III的RFS (HR, 0.6; 95% CI, 0.3-0.9; P = 0.02)，但在RCB-I （HR, 1.1; 95% CI, 0.2-6.5; P = 0.93）或RCB-II （HR, 0.9; 95% CI, 0.7-1.4; P = 0.84）中没有改善。在RCB-III中，卡培他滨组远端转移发生率低于观察组（34.0% vs. 62.9%）。结论：辅助卡培他滨对RCB-III疾病患者最有益，主要是通过减少远处转移。这些发现支持在高危TNBC人群中选择性使用。
{"title":"Clinical Benefit of Adjuvant Capecitabine According To Residual Cancer Burden in Patients With Triple-Negative Breast Cancer With Residual Disease Following Neoadjuvant Chemotherapy","authors":"Shinyoung Lee , Hyehyun Jeong , Eunju Shin , Sae Byul Lee , Jae Ho Jeong , Hee Jin Lee , Gyungyub Gong , Min-Ju Kim , Hee Jeong Kim , Jong Won Lee , Byung-Ho Son , Jaewon Hyung , Jin-Hee Ahn , Kyung Hae Jung , Sung-Bae Kim","doi":"10.1016/j.clbc.2025.09.006","DOIUrl":"10.1016/j.clbc.2025.09.006","url":null,"abstract":"<div><h3>Background</h3><div>In early triple-negative breast cancer (TNBC), surgery following neoadjuvant chemotherapy (NAC) is standard. Adjuvant capecitabine has shown survival benefits in patients with residual disease; however, data remain limited regarding the subgroups that benefit most, particularly when stratified by residual cancer burden (RCB), a key prognostic indicator post-NAC.</div></div><div><h3>Methods</h3><div>Patients with early TNBC and residual disease following NAC (Feb 2008-Dec 2021) were retrospectively included. After propensity score matching to balance baseline characteristics, recurrence-free survival (RFS) was compared between patients who received adjuvant capecitabine and those who did not.</div></div><div><h3>Results</h3><div>Of 828 eligible patients, 631 were included in the final propensity score matched analysis (222 capecitabine; 409 observation). Median ages were 48 years (range, 40-56) and 50 years (range, 41-56) in the observation and capecitabine groups. RCB distribution was comparable between groups: RCB-I (10% vs. 11%), RCB-II (68% in both), and RCB-III (22% vs. 21%). RCB was prognostic across the cohort, with 3-year RFS rates of 92.2%, 73.6%, and 43.3% for RCB-I, -II, and -III, respectively. Adjuvant capecitabine improved RFS in RCB-III (HR, 0.6; 95% CI, 0.3-0.9; <em>P</em> = .02), but not in RCB-I (HR, 1.1; 95% CI, 0.2-6.5; <em>P</em> = .93) or RCB-II (HR, 0.9; 95% CI, 0.7-1.4; <em>P</em> = .84). In RCB-III, distant metastasis occurred less frequently in the capecitabine group compared with the observation group (34.0% vs. 62.9%).</div></div><div><h3>Conclusion</h3><div>Adjuvant capecitabine was most beneficial in patients with RCB-III disease, primarily through a reduction in distant metastasis. These findings support its selective use in high-risk TNBC populations.</div></div>","PeriodicalId":10197,"journal":{"name":"Clinical breast cancer","volume":"26 2","pages":"Pages 248-258.e2"},"PeriodicalIF":2.5,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145328439","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 : 2026-02-01Epub Date: 2025-10-03DOI: 10.1016/j.clbc.2025.09.017
Jessé Lopes da Silva , Luís Felipe Leite da Silva , Wallace Klein Schwengber , Lucas Zanetti de Albuquerque , Natália Cristina Cardoso Nunes , Andréia Cristina de Melo
To evaluate the efficacy and safety of neoadjuvant chemoimmunotherapy in patients with early-stage estrogen receptor (ER)-low/HER2-negative breast cancer (BC), a population often overlooked in clinical trials. A systematic review and meta-analysis were conducted following preferred reporting items for systematic reviews and meta-analyses (PRISMA) standards and registered with PROSPERO. Comprehensive searches were performed across PubMed, Cochrane CENTRAL, Embase, and major oncology conferences for studies with data on neoadjuvant chemoimmunotherapy in ER-low BC. The primary endpoint was the pathologic complete response (pCR) rate, with a secondary descriptive analysis of safety data. Seven studies encompassing 260 patients with ER-low BC were included (3 cohorts and 4 clinical trials). All studies utilized humanized anti-PD-1 antibodies, with 4 administering pembrolizumab, 1 using nivolumab, and 1 employing camrelizumab. The overall pooled pCR rate for ER-low BC was 64.88% (95% confidence interval [CI], 56.72%-73.04%; I² = 37.5%). No significant differences in pCR rates were identified between clinical trials and cohort studies (P = .724). Adverse event data were reported in 2 studies, revealing that 34.4% of patients experienced hospitalizations, with notable rates of grade ≥ 3 adverse events (AEs) and immune-related AEs (irAEs). Neoadjuvant chemoimmunotherapy shows high rates of pCR for ER-low BC, resembling triple-negative BC, with safety data indicating fewer severe complications than observed in pivotal trials.
{"title":"Evaluating the Efficacy and Safety of NEOadjuvant CHEmoimmunotherapy in Early ER-Low/HER2-Negative Breast Cancer (NEOCHEER): A Systematic Review and Meta-Analysis","authors":"Jessé Lopes da Silva , Luís Felipe Leite da Silva , Wallace Klein Schwengber , Lucas Zanetti de Albuquerque , Natália Cristina Cardoso Nunes , Andréia Cristina de Melo","doi":"10.1016/j.clbc.2025.09.017","DOIUrl":"10.1016/j.clbc.2025.09.017","url":null,"abstract":"<div><div>To evaluate the efficacy and safety of neoadjuvant chemoimmunotherapy in patients with early-stage estrogen receptor (ER)-low/HER2-negative breast cancer (BC), a population often overlooked in clinical trials. A systematic review and meta-analysis were conducted following preferred reporting items for systematic reviews and meta-analyses (PRISMA) standards and registered with PROSPERO. Comprehensive searches were performed across PubMed, Cochrane CENTRAL, Embase, and major oncology conferences for studies with data on neoadjuvant chemoimmunotherapy in ER-low BC. The primary endpoint was the pathologic complete response (pCR) rate, with a secondary descriptive analysis of safety data. Seven studies encompassing 260 patients with ER-low BC were included (3 cohorts and 4 clinical trials). All studies utilized humanized anti-PD-1 antibodies, with 4 administering pembrolizumab, 1 using nivolumab, and 1 employing camrelizumab. The overall pooled pCR rate for ER-low BC was 64.88% (95% confidence interval [CI], 56.72%-73.04%; I² = 37.5%). No significant differences in pCR rates were identified between clinical trials and cohort studies (<em>P</em> = .724). Adverse event data were reported in 2 studies, revealing that 34.4% of patients experienced hospitalizations, with notable rates of grade ≥ 3 adverse events (AEs) and immune-related AEs (irAEs). Neoadjuvant chemoimmunotherapy shows high rates of pCR for ER-low BC, resembling triple-negative BC, with safety data indicating fewer severe complications than observed in pivotal trials.</div></div>","PeriodicalId":10197,"journal":{"name":"Clinical breast cancer","volume":"26 2","pages":"Pages 296-303"},"PeriodicalIF":2.5,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145421343","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 : 2026-02-01Epub Date: 2025-08-24DOI: 10.1016/j.clbc.2025.08.015
Alisha A. Jaffer , Carolyn Cullinane , Matthew G Davey , Amirhossein Jalali , Juliette Buckley , Chwanrow Baban , Brigid Anne Merrigan , Shona Tormey
Background
Neutrophil-lymphocyte ratio (NLR) is an emerging prognostic biomarker with potential utility in solid malignancies. Routine draw of full blood count in preoperative workup positions NLR as a cost-effective adjunct in risk stratification. This project explores associations between preoperative NLR and breast cancer outcomes.
Methods
This retrospective cohort study reviewed an institutional database of breast cancer patients undergoing primary curative surgery at University Hospital Limerick from January 1, 2010 to June 1, 2017. Primary endpoints included recurrence at 5 years, disease free survival (DFS) and OS (OS). Regression modelling examined associations between preoperative NLR ≥2.5 and endpoints, controlling for confounders.
Results
Median preoperative NLR was 2.63 (SD 1.42). The cohort comprised 579 patients, with a recurrence rate of 15.7% (6% local recurrence and 9.7% distant metastasis). 106 (18.3%) patients were deceased at the administrative censoring time. Patients with NLR ≥ 2.5 had a 2-fold increase in rate of distant metastasis at 5 years (OR 2.00, 95% CI, 1.05-3.81, P = .036) and experienced worse OS (HR 1.84, 95% CI, 1.20-2.84, P = .006). Outcomes between NLR ≥2.5 and local recurrence at 5 years, as well as NLR ≥2.5 and DFS were equivocal.
Conclusions
Preoperative NLR ≥2.5 was found to be an independent predictor of distant metastasis at 5 years and an independent predictor of OS, following adjustment of confounders. This finding is consistent with published literature and may help risk stratify patients at higher risk of breast cancer recurrence.
背景：中性粒细胞-淋巴细胞比率（NLR）是一种新兴的预后生物标志物，在实体恶性肿瘤中具有潜在的应用价值。在术前检查中常规抽取全血细胞计数使NLR在风险分层中成为一种具有成本效益的辅助手段。本项目探讨术前NLR与乳腺癌预后之间的关系。方法：本回顾性队列研究回顾了2010年1月1日至2017年6月1日在利默里克大学医院接受初级治疗性手术的乳腺癌患者的机构数据库。主要终点包括5年复发、无病生存期（DFS）和OS。回归模型检验了术前NLR≥2.5与终点之间的关系，控制了混杂因素。结果：术前NLR中位数为2.63 （SD 1.42）。该队列包括579例患者，复发率为15.7%（局部复发6%，远处转移9.7%）。106例（18.3%）患者在行政审查时死亡。NLR≥2.5的患者5年远处转移率增加2倍（OR 2.00, 95% CI, 1.05-3.81, P = 0.036）， OS更差（HR 1.84, 95% CI, 1.20-2.84, P = 0.006）。NLR≥2.5与5年局部复发、NLR≥2.5与DFS之间的结果是模棱两可的。结论：在调整混杂因素后，术前NLR≥2.5是5年远处转移的独立预测因子，也是OS的独立预测因子。这一发现与已发表的文献一致，可能有助于对乳腺癌复发风险较高的患者进行风险分层。
{"title":"Evaluating the Neutrophil-Lymphocyte Ratio as a Predictor of Long-Term Oncological and Survival Outcomes in Patients Treated Surgically for Breast Cancer","authors":"Alisha A. Jaffer , Carolyn Cullinane , Matthew G Davey , Amirhossein Jalali , Juliette Buckley , Chwanrow Baban , Brigid Anne Merrigan , Shona Tormey","doi":"10.1016/j.clbc.2025.08.015","DOIUrl":"10.1016/j.clbc.2025.08.015","url":null,"abstract":"<div><h3>Background</h3><div>Neutrophil-lymphocyte ratio (NLR) is an emerging prognostic biomarker with potential utility in solid malignancies. Routine draw of full blood count in preoperative workup positions NLR as a cost-effective adjunct in risk stratification. This project explores associations between preoperative NLR and breast cancer outcomes.</div></div><div><h3>Methods</h3><div>This retrospective cohort study reviewed an institutional database of breast cancer patients undergoing primary curative surgery at University Hospital Limerick from January 1, 2010 to June 1, 2017. Primary endpoints included recurrence at 5 years, disease free survival (DFS) and OS (OS). Regression modelling examined associations between preoperative NLR ≥2.5 and endpoints, controlling for confounders.</div></div><div><h3>Results</h3><div>Median preoperative NLR was 2.63 (SD 1.42). The cohort comprised 579 patients, with a recurrence rate of 15.7% (6% local recurrence and 9.7% distant metastasis). 106 (18.3%) patients were deceased at the administrative censoring time. Patients with NLR ≥ 2.5 had a 2-fold increase in rate of distant metastasis at 5 years (OR 2.00, 95% CI, 1.05-3.81, <em>P</em> = .036) and experienced worse OS (HR 1.84, 95% CI, 1.20-2.84, <em>P</em> = .006). Outcomes between NLR ≥2.5 and local recurrence at 5 years, as well as NLR ≥2.5 and DFS were equivocal.</div></div><div><h3>Conclusions</h3><div>Preoperative NLR ≥2.5 was found to be an independent predictor of distant metastasis at 5 years and an independent predictor of OS, following adjustment of confounders. This finding is consistent with published literature and may help risk stratify patients at higher risk of breast cancer recurrence.</div></div>","PeriodicalId":10197,"journal":{"name":"Clinical breast cancer","volume":"26 2","pages":"Pages 136-145.e2"},"PeriodicalIF":2.5,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145111533","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}
Breast cancer ranks as the second most significant cause of cancer-related mortality on a global scale, with its incidence demonstrating a continual upward trajectory. Investigating gene targets for cancer therapies has advanced through innovative methodologies focusing on genes and pathways driving cancer progression. A disintegrin and metalloproteinases (ADAMs) and ADAMs with thrombospondin motifs (ADAMTSs) constitute related protease families, with ADAMs primarily functioning as membrane-anchored cell-surface enzymes and ADAMTSs secreted into the extracellular matrix. These proteases drive oncogenic signaling via ectodomain shedding of growth factors and receptors, modulating EGFR, PI3K/AKT/mTOR, TNF-α, Notch, and JAK-STAT pathways. ADAM10 and ADAM17 particularly promote breast cancer invasion and metastasis in HER2-positive and triple-negative subtypes, establishing them as biomarkers and therapeutic targets. Conversely, certain ADAMTS members exhibit tumor-suppressive functions by inhibiting angiogenesis and ECM remodeling. Regulatory cofactors such as iRhom proteins modulate ADAM17 maturation and substrate selectivity, adding complexity to this proteolytic network. This review synthesizes recent advances in ADAMs/ADAMTs in breast cancer, highlighting roles in promoting or suppressing tumorigenesis depending on isoform and molecular context. Multiple therapeutic modalities have been validated, including small-molecule inhibitors (INCB7839, INCB3619, GI254023X) that suppress ligand shedding and enhance trastuzumab efficacy, RNA interference (siRNA/miRNA) for targeted gene silencing, and engineered nanocarrier drug delivery platforms that overcome therapeutic resistance. The epigenetic regulation, post-translational modifications, and diagnostic advancements, such as SERS-based serum profiling, further underscore their value as biomarkers and druggable targets. Collectively, ADAM/ADAMTS-centered interventions represent a promising direction for precision oncology and therapeutic targets for improving clinical outcomes in breast cancer.
{"title":"ADAM and ADAMTS Proteases in Breast Cancer: Molecular Mechanisms and Therapeutic Implications","authors":"Chanchal Badhai, Manju Rawat Singh PhD, Shradha Devi Dwivedi, Deependra Singh","doi":"10.1016/j.clbc.2025.12.001","DOIUrl":"10.1016/j.clbc.2025.12.001","url":null,"abstract":"<div><div>Breast cancer ranks as the second most significant cause of cancer-related mortality on a global scale, with its incidence demonstrating a continual upward trajectory. Investigating gene targets for cancer therapies has advanced through innovative methodologies focusing on genes and pathways driving cancer progression. A disintegrin and metalloproteinases (ADAMs) and ADAMs with thrombospondin motifs (ADAMTSs) constitute related protease families, with ADAMs primarily functioning as membrane-anchored cell-surface enzymes and ADAMTSs secreted into the extracellular matrix. These proteases drive oncogenic signaling via ectodomain shedding of growth factors and receptors, modulating EGFR, PI3K/AKT/mTOR, TNF-α, Notch, and JAK-STAT pathways. ADAM10 and ADAM17 particularly promote breast cancer invasion and metastasis in HER2-positive and triple-negative subtypes, establishing them as biomarkers and therapeutic targets. Conversely, certain ADAMTS members exhibit tumor-suppressive functions by inhibiting angiogenesis and ECM remodeling. Regulatory cofactors such as iRhom proteins modulate ADAM17 maturation and substrate selectivity, adding complexity to this proteolytic network. This review synthesizes recent advances in ADAMs/ADAMTs in breast cancer, highlighting roles in promoting or suppressing tumorigenesis depending on isoform and molecular context. Multiple therapeutic modalities have been validated, including small-molecule inhibitors (INCB7839, INCB3619, GI254023X) that suppress ligand shedding and enhance trastuzumab efficacy, RNA interference (siRNA/miRNA) for targeted gene silencing, and engineered nanocarrier drug delivery platforms that overcome therapeutic resistance. The epigenetic regulation, post-translational modifications, and diagnostic advancements, such as SERS-based serum profiling, further underscore their value as biomarkers and druggable targets. Collectively, ADAM/ADAMTS-centered interventions represent a promising direction for precision oncology and therapeutic targets for improving clinical outcomes in breast cancer.</div></div>","PeriodicalId":10197,"journal":{"name":"Clinical breast cancer","volume":"26 2","pages":"Pages 17-35"},"PeriodicalIF":2.5,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145908801","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 : 2026-02-01Epub Date: 2025-12-13DOI: 10.1016/j.clbc.2025.11.012
Charles A. Keane , Magdalena A. Iannello , Sumeet S. Teotia , Nicholas T. Haddock , Lisa Wintonli
Purpose
This study aimed to assess the rates of breast conservation therapy and mastectomy with and without immediate postmastectomy reconstruction (IPMR) amongst racially distinct subgroups being treated with neoadjuvant chemotherapy (NAC).
Methods
Women who received NAC for newly diagnosed breast cancer from 2010 to 2017 were identified from an institutional tumor registry at a tertiary care center and an associated safety-net institution. Patient demographics, insurance status, tumor characteristics, and surgical procedures were compared after women were stratified by race.
Results
At the tertiary care facility, a higher proportion of White women were treated with bilateral mastectomy (35.7%) compared to Black (19.3%) and Hispanic women (9.8%). White women were also more likely to receive IPMR as compared to Black and Hispanic women (63.7% vs. 42.7% and 33.3% respectively). At the associated safety-net institution, women were more likely to undergo a unilateral mastectomy, regardless of race, and there was no statistical difference in the rates of IPMR amongst the different racial cohorts (17.2%-18.7%). IPMR was performed in 52.4% of cases at the tertiary care center compared to 18.2% at the safety-net institution.
Conclusion
Despite controlling for confounding factors, disparities exist in the treatment of breast cancer patients. This study focuses on differing rates of mastectomy and IPMR when comparing an associated tertiary care center and safety-net institution. The discrepancy is profound and appears to be driven by race, insurance, and institution type.
{"title":"Comparing Surgical Management and Reconstruction of Breast Cancer Patients at a Tertiary Care Center and an Associated Safety-Net Institution","authors":"Charles A. Keane , Magdalena A. Iannello , Sumeet S. Teotia , Nicholas T. Haddock , Lisa Wintonli","doi":"10.1016/j.clbc.2025.11.012","DOIUrl":"10.1016/j.clbc.2025.11.012","url":null,"abstract":"<div><h3>Purpose</h3><div>This study aimed to assess the rates of breast conservation therapy and mastectomy with and without immediate postmastectomy reconstruction (IPMR) amongst racially distinct subgroups being treated with neoadjuvant chemotherapy (NAC).</div></div><div><h3>Methods</h3><div>Women who received NAC for newly diagnosed breast cancer from 2010 to 2017 were identified from an institutional tumor registry at a tertiary care center and an associated safety-net institution. Patient demographics, insurance status, tumor characteristics, and surgical procedures were compared after women were stratified by race.</div></div><div><h3>Results</h3><div>At the tertiary care facility, a higher proportion of White women were treated with bilateral mastectomy (35.7%) compared to Black (19.3%) and Hispanic women (9.8%). White women were also more likely to receive IPMR as compared to Black and Hispanic women (63.7% vs. 42.7% and 33.3% respectively). At the associated safety-net institution, women were more likely to undergo a unilateral mastectomy, regardless of race, and there was no statistical difference in the rates of IPMR amongst the different racial cohorts (17.2%-18.7%). IPMR was performed in 52.4% of cases at the tertiary care center compared to 18.2% at the safety-net institution.</div></div><div><h3>Conclusion</h3><div>Despite controlling for confounding factors, disparities exist in the treatment of breast cancer patients. This study focuses on differing rates of mastectomy and IPMR when comparing an associated tertiary care center and safety-net institution. The discrepancy is profound and appears to be driven by race, insurance, and institution type.</div></div>","PeriodicalId":10197,"journal":{"name":"Clinical breast cancer","volume":"26 2","pages":"Pages 45-49"},"PeriodicalIF":2.5,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146017607","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 : 2026-02-01Epub 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 , Expert Panel on Breast Cancer
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 , Expert Panel on Breast Cancer","doi":"10.1016/j.clbc.2025.12.007","DOIUrl":"10.1016/j.clbc.2025.12.007","url":null,"abstract":"<div><div>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.</div></div>","PeriodicalId":10197,"journal":{"name":"Clinical breast cancer","volume":"26 2","pages":"Pages 105-112"},"PeriodicalIF":2.5,"publicationDate":"2026-02-01","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}
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