Clinical breast cancer最新文献

{"title":"When Obesity Meets Lymphedema: Interaction Effects on Lymphatic Pain Among Chinese Breast Cancer Survivors","authors":"Aomei Shen ,&nbsp;Yuhua Yang ,&nbsp;Li Zhang ,&nbsp;Nada Lukkahatai ,&nbsp;Mei R. Fu ,&nbsp;Shengwen Dong ,&nbsp;Ying Wang ,&nbsp;Hongmeng Zhao ,&nbsp;Peipei Wu ,&nbsp;Pan Yang ,&nbsp;Qian Lu","doi":"10.1016/j.clbc.2025.12.002","DOIUrl":"10.1016/j.clbc.2025.12.002","url":null,"abstract":"<div><h3>Background</h3><div>Lymphatic pain is an underrecognized symptom among breast cancer survivors and may indicate early lymphatic dysfunction. This study examined the prevalence of lymphatic pain and its associated factors, with a particular focus on the interaction between obesity and breast cancer-related lymphedema (BCRL).</div></div><div><h3>Methods</h3><div>A secondary analysis was conducted using datasets from 2 previously completed studies. 894 participants who completed arm circumference measurements and symptom assessments were included. Independent t-tests, chi-square tests, Fisher’s exact tests, and binary logistic regression analyses were performed to explore group differences and potential predictors of lymphatic pain. An interaction term between obesity and BCRL was incorporated to evaluate effect modification.</div></div><div><h3>Results</h3><div>The prevalence of lymphatic pain was 18.12% (<em>n</em> = 162, 95% CI, 15.8%-20.8%). Participants with lymphatic pain reported a greater number, higher severity, and higher frequency of all symptoms compared to those without lymphatic pain (all <em>P</em> &lt; .001). BCRL was the strongest independent predictor of lymphatic pain (OR = 2.955, 95% CI, 1.957-4.460). Although the main effect of obesity was not statistically significant, a significant obesity × BCRL interaction was identified (<em>P</em> = .032). Predicted probabilities indicated that obesity had minimal effect among participants without BCRL, but increased lymphatic pain risk among those with BCRL.</div></div><div><h3>Conclusion</h3><div>Obesity and BCRL are key factors associated with lymphatic pain, and obesity markedly amplifies pain risk in the presence of BCRL. These findings highlight the need for early lymphatic assessment and weight-management–informed survivorship care. Ongoing research is needed to clarify mechanisms and to evaluate targeted interventions.</div></div>","PeriodicalId":10197,"journal":{"name":"Clinical breast cancer","volume":"26 2","pages":"Pages 36-44"},"PeriodicalIF":2.5,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145951706","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Practical Considerations for the Use of Antiemetics in Pregnant Patients With Breast Cancer","authors":"Arianne Duong ,&nbsp;Dane Fritzsche ,&nbsp;Amy Ly Indorf","doi":"10.1016/j.clbc.2025.12.012","DOIUrl":"10.1016/j.clbc.2025.12.012","url":null,"abstract":"<div><div>Early breast cancer treatment commonly includes highly emetogenic chemotherapy and immunotherapy regimens. Both pregnancy and chemotherapy treatment are associated with nausea and vomiting, and many agents used to treat pregnancy-associated nausea have limited data for CINV. Guidelines recommend a 4-drug antiemetic regimen for highly emetogenic chemotherapy regimens. Designing antiemetic regimens for pregnant women undergoing treatment for early breast cancer remains a challenge because of a lack of safety data for commonly used antiemetics as well as physiologic changes that occur throughout pregnancy This review aims to discuss current literature and guideline recommendations and provide practical considerations for agents used in chemotherapy-induced nausea and vomiting prevention in pregnant patients with breast cancer. A literature search on nausea pathophysiology, treatment of pregnant breast cancer patients, antiemetic use in pregnancy and chemotherapy-induced nausea and vomiting was conducted. Primary and tertiary literature sources were reviewed and cited. An overview of nausea pathophysiology and general treatment principles of treatment and supportive care in pregnant breast cancer patients is outlined. Five major antiemetic drug classes are reviewed in this article. When designing antiemetic regimens for pregnant patients undergoing chemotherapy treatment, clinicians must consider the current evidence, including safety, side effects, and pharmacokinetics of various agents, as well as pregnancy trimester and associated physiologic changes. Optimal management and prevention of chemotherapy-induced nausea and vomiting is crucial to avoid treatment delays and hospitalization, and to maximize patient quality of life.</div></div>","PeriodicalId":10197,"journal":{"name":"Clinical breast cancer","volume":"26 2","pages":"Pages 80-86"},"PeriodicalIF":2.5,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146035522","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patient-Provider Relationships Influence Reception of Postmastectomy Breast Reconstruction: An Analysis of the All of Us Research Program","authors":"Dylan K. Kim,&nbsp;Hao Huang,&nbsp;Julia A. Kim,&nbsp;Christine H. Rohde","doi":"10.1016/j.clbc.2025.09.016","DOIUrl":"10.1016/j.clbc.2025.09.016","url":null,"abstract":"<div><h3>Background</h3><div>Although existing literature has comprehensively investigated socioeconomic disparities in postmastectomy breast reconstruction, the effect of patient-provider relationships on the receipt of breast reconstruction is still not completely described. This study incorporates a large national data platform to investigate the effect of such interactions on the likelihood of reconstruction after mastectomy.</div></div><div><h3>Methods</h3><div>Patients who underwent mastectomy were identified in the All of Us Research Program, a large and diverse United States patient registry. Patient-provider relationships were quantified through a series of survey questions assessing themes of respect, understanding, and apprehension from patient-provider interactions. The main outcome of interest was the receipt of breast reconstruction, which was assessed with multivariable logistic regression (<em>P</em> &lt; .05).</div></div><div><h3>Results</h3><div>The final cohort included 547 patients with complete survey data. The rate of postmastectomy breast reconstruction was 47.3%. Patient perceptions of receiving respectful treatment by providers “most of the time” (OR: 0.47, 95% CI, 0.30-0.74, <em>P</em> = .0012) and “some of the time” (OR: 0.21, 95% CI, 0.05-0.89, <em>P</em> = .034) predicted lower odds of breast reconstruction when compared to “always.” Nervousness about seeing a health care provider was also associated with lower odds of breast reconstruction (OR: 0.51, 95% CI, 0.27-0.96, <em>P</em> = .034).</div></div><div><h3>Conclusion</h3><div>Despite increasing volume of breast reconstruction in the United States, the receipt of such reconstruction may still be influenced by aspects of the patient-provider relationship. This analysis supports the importance of cultivating patient-centered relationships for patients with breast cancer.</div></div>","PeriodicalId":10197,"journal":{"name":"Clinical breast cancer","volume":"26 2","pages":"Pages 287-295"},"PeriodicalIF":2.5,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145354086","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnostic Performance of AI-Assisted Radiologists in Breast Cancer Detection Using Digital Mammography: A Systematic Review and Meta-Analysis","authors":"Jiayin Lu ,&nbsp;Xiaonan Xu ,&nbsp;Yanyan Zhang ,&nbsp;Kunyu Zhuang ,&nbsp;Tali Fang ,&nbsp;Chifa Zhang ,&nbsp;Kairong Chen ,&nbsp;Xiaomei Huang ,&nbsp;Yingjia Li","doi":"10.1016/j.clbc.2025.08.013","DOIUrl":"10.1016/j.clbc.2025.08.013","url":null,"abstract":"<div><div>To evaluate the diagnostic performance of AI-assisted and standalone human radiologists in breast cancer detection using digital mammography (DM). A comprehensive search was conducted in PubMed, Web of Science, Embase, Cochrane Library, and Scopus databases for studies published from January 2019 to December 2024. Study quality was assessed using the quality assessment of diagnostic accuracy studies 2 (QUADAS-2) and quality assessment of diagnostic accuracy studies-comparative (QUADAS-C). Summary receiver operating characteristic (SROC) curves and prediction regions of pooled sensitivity, specificity, and estimated area under the curves (AUCs) were used to evaluate the diagnostic performance of AI-assisted radiologists versus standalone human radiologists. Sources of heterogeneity were explored using meta-regression analysis. Overall, 30 studies were included in the qualitative synthesis. Among them, data from 20 studies were separately utilized for quantitative synthesis, categorized into three scenario groups: concurrent assistant, AI reader-replacement, and additional reader scenarios. Pooled sensitivity was significantly higher for AI-assisted radiologists compared to standalone human radiologists in the concurrent scenario (0.84 vs. 0.78, <em>P</em> &lt; .001), and pooled specificity was superior in the concurrent and replacement scenarios, respectively (0.84 vs. 0.80, <em>P</em> &lt; .001; 0.96 vs. 0.95, <em>P</em> &lt; .001). There were no significant differences in area under the curves (AUCs) among these three scenarios. In breast cancer diagnosis, AI-assisted radiologists demonstrated superior sensitivity compared to standalone human radiologists in the concurrent scenario, and superior specificity in both the concurrent and replacement scenarios. Further research is needed to confirm these findings and explore the optimal strategies for integrating AI into breast cancer diagnostic workflows.</div></div>","PeriodicalId":10197,"journal":{"name":"Clinical breast cancer","volume":"26 2","pages":"Pages 121-135"},"PeriodicalIF":2.5,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145063608","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Robot-Assisted Versus Open Surgery in Early-Stage Breast Cancer: A Systematic Review and Meta-Analysis","authors":"Shrouk Elghazaly ,&nbsp;Sara Fakeh ,&nbsp;Shaymaa Elbarbary ,&nbsp;Khaled Mahmoud ,&nbsp;Abdeljalil El Hilali ,&nbsp;Peter Gamal ,&nbsp;Elsayed Motawa","doi":"10.1016/j.clbc.2025.08.019","DOIUrl":"10.1016/j.clbc.2025.08.019","url":null,"abstract":"<div><h3>Background</h3><div>Breast cancer is the most frequently diagnosed malignancy among women and remains a leading cause of cancer-related mortality. Nipple-sparing mastectomy (NSM), especially when combined with immediate reconstruction, has demonstrated oncologic safety and improved aesthetic outcomes. Robotic-assisted NSM (R-NSM) is a recent advancement offering better visualization and minimally invasive benefits, though its long-term safety and effectiveness remain under evaluation.</div></div><div><h3>Methods</h3><div>Databases searched included PubMed, Scopus, Web of Science, and the Cochrane Library. Eligible studies compared R-NSM with open NSM for early-stage breast cancer and reported surgical or oncologic outcomes.</div></div><div><h3>Results</h3><div>Eight studies including 1743 patients were included in the meta-analysis. R-NSM was associated with a significantly longer operative time (mean difference: 47.95 minutes; 95% CI, 13.89-82.02) but significantly lower intraoperative blood loss (mean difference: −34.29 mL; 95% CI, −43.63 to −24.95). Major complication risk was also lower (RR: 0.45; 95% CI, 0.23-0.86). Nipple-areola complex necrosis was significantly lower in R-NSM (RR: 0.55; 95% CI, 0.35-0.88). No significant differences were observed for skin necrosis, seroma, or surgical site infections. Heterogeneity was high in several outcomes.</div></div><div><h3>Discussion</h3><div>R-NSM may improve perioperative outcomes by enabling precise dissection through remote incisions, potentially preserving vascular supply to the nipple–areola complex and reducing severe complications. The trade-off is longer operative time, largely due to robotic system setup and surgeons experience.</div></div><div><h3>Conclusion</h3><div>Robotic-assisted NSM reduces blood loss and major complication at the cost of longer operative times. Further high-quality studies are needed to confirm its long-term oncologic outcomes and guide patient selection.</div></div>","PeriodicalId":10197,"journal":{"name":"Clinical breast cancer","volume":"26 2","pages":"Pages 181-190"},"PeriodicalIF":2.5,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145079736","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical Implementation Study of Genetic Risk-Based Breast Cancer Screening","authors":"Madli Tamm ,&nbsp;Peeter Padrik ,&nbsp;Kristiina Ojamaa ,&nbsp;Anette Paas ,&nbsp;Anni Lepland ,&nbsp;Krista Kruuv-Käo ,&nbsp;Liis Leitsalu ,&nbsp;Siim Sõber ,&nbsp;Laura Roht ,&nbsp;Sander Pajusalu ,&nbsp;Tiina Kahre ,&nbsp;Anna Padrik ,&nbsp;Jagnar Pindmaa ,&nbsp;Kadri Luga ,&nbsp;Ly Rootslane ,&nbsp;Anne Ilves ,&nbsp;Sulev Ulp ,&nbsp;Kersti Kallak ,&nbsp;Ave-Triin Tihamäe ,&nbsp;Inna Feldman ,&nbsp;Neeme Tõnisson","doi":"10.1016/j.clbc.2025.08.021","DOIUrl":"10.1016/j.clbc.2025.08.021","url":null,"abstract":"<div><h3>Background</h3><div>Breast cancer (BC) remains the most common type of cancer and the leading cause of cancer-related deaths in women despite the widespread screening programs and personalized treatment options. Current age-based screening programs are suboptimal missing high-risk young women. The “Be RIGHT with breast cancer risk management” (BRIGHT) study evaluated a genetic risk-based personalized BC screening service model in real-world healthcare settings, focusing on younger women excluded from standard screening.</div></div><div><h3>Methods</h3><div>The BRIGHT study included 800 healthy Estonian women aged 35 to 49 using telemedicine and home-based testing. Participants underwent polygenic risk score (PRS) testing and based on the questionnaire those meeting the monogenic pathogenic variant (MPV) testing criteria were referred to clinical geneticists. All women received personalized genetic risk-based clinical recommendations, and if needed, referral to BC screening. Participants’ and healthcare professionals’ feedback was collected.</div></div><div><h3>Results</h3><div>330 (41.3%) women with elevated polygenic risk received recommendations to start screening earlier than the current standard. 124 (15.5%) women were advised to begin BC screening immediately, among whom one was diagnosed with stage 0 cancer and one with a precancerous lesion. Of the 90 participants completing MPV testing, four (4.4%) were MPV-positive. Feedback indicated high satisfaction with the digital approach and a clear understanding of results and recommendations.</div></div><div><h3>Conclusions</h3><div>The study demonstrated the feasibility and acceptability of a personalized genetic risk-based BC screening model. It has the potential to enhance BC screening programs, particularly for younger women and those at higher genetic risk, while avoiding unnecessary interventions for low-risk individuals.</div></div>","PeriodicalId":10197,"journal":{"name":"Clinical breast cancer","volume":"26 2","pages":"Pages 204-215"},"PeriodicalIF":2.5,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145408461","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An Individual Patient Data Meta-Analysis on the Characteristics, Treatments, and Outcomes of the Patients With Neuroendocrine Neoplasm of the Breast Reported in Literature Until August 2024","authors":"Lena Schnell ,&nbsp;Helmut Orawa ,&nbsp;Georg W. Wurschi ,&nbsp;Klaus Pietschmann","doi":"10.1016/j.clbc.2025.08.016","DOIUrl":"10.1016/j.clbc.2025.08.016","url":null,"abstract":"<div><div>Neuroendocrine neoplasm (NEN) of the breast is a rare type of breast cancer with limited knowledge about its characteristics and optimal management. The diagnostic criteria have been constantly updated by the World Health Organization (WHO) with increasing understanding, most recently in 2019. Focusing on characteristics, treatments and outcomes, we performed a comprehensive individual patient data (IPD) meta-analysis of the cases reported in literature between 2003 and August 2024. PubMed and Web of Science were searched systematically for case reports using predefined search terms. The protocol was prospectively registered with the international prospective register of systematic reviews (PROSPERO CRD42022356345). 185 publications, consisting of case reports or small case series published between 2003 and 2024, were eligible. They reported on 202 patients. Median age at diagnosis was 54 years (range 13-86). The 5-year overall survival proportion was 77%. On univariable analysis, overall survival was significantly influenced by regional and distant metastases, histologic grading, receptor status, Ki-67 index and surgical intervention. We did not observe any significant outcome improvement over time. Only poorly differentiated neuroendocrine carcinoma and lack of surgery were found to be prognostic factors for poor overall survival in multivariable analysis. This rare subtype of breast cancer is associated with a poor prognosis with no meaningful treatment progress in the last 2 decades. The present study identified key prognostic factors. However, the available data are insufficient to determine the optimal treatment approach. Establishing uniform diagnostic criteria and consistently reporting cases is crucial to generate a larger pool of data, thereby advancing our understanding and management of this rare disease.</div></div>","PeriodicalId":10197,"journal":{"name":"Clinical breast cancer","volume":"26 2","pages":"Pages 146-160"},"PeriodicalIF":2.5,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145174063","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cost Analysis of Technetium-99m versus Indocyanine Green for Sentinel Lymph Node Biopsy in Breast Cancer","authors":"Iva M. Borisova Boyanova ,&nbsp;Lidia Blay Aulina ,&nbsp;Marta de la Iglésia ,&nbsp;David López-Cano ,&nbsp;Cristina Serra-Serra ,&nbsp;Neus Ruiz-Edo ,&nbsp;Maite Salcedo-Pujantell ,&nbsp;Juan Francisco Julián Ibañéz ,&nbsp;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":"2026-02-01","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}

{"title":"Relationship Between Census Tract-Level Social Determinants of Health and Cardiovascular Care among Individuals Diagnosed With Breast Cancer","authors":"Pei-Lin Huang ,&nbsp;Manu M. Mysore ,&nbsp;Brian Barr ,&nbsp;Eberechukwu Onukwugha","doi":"10.1016/j.clbc.2025.08.020","DOIUrl":"10.1016/j.clbc.2025.08.020","url":null,"abstract":"<div><h3>Purpose</h3><div>Cardiovascular care is impacted by social determinants of health (SDoH), however implications for physician visits among individuals diagnosed with breast cancer (BC) who received potentially cardio-toxic treatments (PCT) are poorly understood. We investigate these relationships among older adults.</div></div><div><h3>Methods</h3><div>This study used Surveillance, Epidemiology, and End Results-Medicare data linked with Census tract SDoH measures. We included female patients diagnosed with BC between 2007 and 2018 who received PCT within 12 months of diagnosis. Framework-guided tract-level SDoH variables and empirically-derived tract-level SDoH domains were used in separate regression models. Study outcomes included cardiologist or primary care physician (PCP) visits within 90 days of treatment and time to first physician visit. Logistic regression and Cox proportional hazards models included patient- and tract-level measures.</div></div><div><h3>Results</h3><div>A total of 2637 patients were included. Living in a low food access tract (aOR: 0.78, 95%CI: 0.63-0.96) and a primary care health professional shortage area (aOR: 0.66, 95%CI: 0.52-0.84) were associated with lower odds of first cardiologist visit within 90 days of treatment. Living in a tract ranked higher on the empirical domain of “poor community infrastructure and inequity” was associated with a longer time to a first cardiologist visit (aHR: 0.90, 95%CI: 0.81-0.99).</div></div><div><h3>Conclusions</h3><div>Individuals residing in worse-off tracts experienced barriers to physician visits following PCT initiation. “poor community infrastructure and inequity,” was associated with a longer time to first cardiologist visit. These findings support incorporating contextual SDoH factors into pretreatment risk assessment tools to better identify patients who may benefit from cardio-oncology referrals.</div></div>","PeriodicalId":10197,"journal":{"name":"Clinical breast cancer","volume":"26 2","pages":"Pages 191-203.e1"},"PeriodicalIF":2.5,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145111671","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Triple Technique (Radioisotope, Blue Dye, and Embedded Fiducial Marker) for Identifying Sentinel Lymph Nodes Following Neoadjuvant Chemotherapy for Clinical Lymph Node Positive Breast Cancer; Is More Really Better?","authors":"Fuzesi Sarah ,&nbsp;Paily Jacienta ,&nbsp;Ha Richard ,&nbsp;Wiechmann Lisa ,&nbsp;Sun Luona ,&nbsp;Rao Roshni ,&nbsp;Taback Bret","doi":"10.1016/j.clbc.2025.12.003","DOIUrl":"10.1016/j.clbc.2025.12.003","url":null,"abstract":"<div><h3>Purpose</h3><div>To determine the accuracy of radioisotope, blue dye and implanted fiducial marker for identification of the histopathologically positive percutaneous/previously biopsied lymph node (PBLN) following neoadjuvant chemotherapy (NAC). Detection of the PBLN is critical for monitoring disease response and guiding subsequent treatment decisions. However, conventional sentinel lymph node biopsy (SLNB) techniques have shown unacceptable false negative rates. Recommendations for improvement suggest using dual tracers, removing more lymph nodes and implantable markers in the PBLN. This study evaluated the accuracy of PBLN identification using each of the 3 most common localization techniques: blue dye (lymphazurin), radioisotope (Technetium-99m sulfur colloid), and implanted fiducial marker (SAVI SCOUT).</div></div><div><h3>Methods</h3><div>Patients with PBLN marked with a SAVI SCOUT, with or without a metallic clip, and who received NAC were identified from our breast cancer surgery database. The accuracy of the 3 localizing techniques was evaluated. Secondary outcomes included total number of lymph nodes retrieved and number of sampling events per patient for each technique.</div></div><div><h3>Results</h3><div>We identified 65 patients who underwent percutaneous lymph node biopsy prior to NAC. The clip marking the PBLN was identified in 64 patients (98%). The PBLN was identified by the SAVI SCOUT in 61 (95%) of 64 patients, radioisotope in 44 (71%) of 62 patients and blue dye in 28 (64%) of 44 patients. A SAVI SCOUT was placed at the time of biopsy instead of a clip in 13 patients and identification of the PBLN was 100% for those patients. The mean number of lymph nodes removed with the SAVI SCOUT was 2.7, with radioisotope was 4.3 and with blue dye was 3.6 (<em>P</em> = .004). The mean number of SLN sampling events with the SAVI SCOUT was 1, with radioisotope was 2.0 (range: 0-6) and with blue dye was 1.8 (range: 0-5) (<em>P</em> &lt; .005). When radioisotope was used, the clip was found in the hottest lymph node 40% of the time, in the second and third hottest lymph node 5% and 11% of the time, respectively. The clipped node was not hot in 29% of cases.</div></div><div><h3>Conclusions</h3><div>This study demonstrates that the most accurate method for identifying the PBLN is with placement of a fiducial marker. Furthermore, the addition of radioisotope and blue dye may result in an excessive number of lymph nodes removed and more retrieval events during SLNB following NAC. Placement of the SAVI SCOUT marker at the time of percutaneous lymph node biopsy may subsequently obviate the need for additional mapping techniques of blue dye and radioisotope during sentinel lymph node surgery.</div></div>","PeriodicalId":10197,"journal":{"name":"Clinical breast cancer","volume":"26 2","pages":"Pages 87-92"},"PeriodicalIF":2.5,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146074577","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}