Clinical breast cancer最新文献_第6页

A Systematic Review With Individual Patient Data Meta-analysis on Characteristics and Outcomes of Patients With Metaplastic Breast Carcinoma 对乳腺癌化生患者的特征和预后进行meta分析的系统综述。

IF 2.5 3区医学 Q2 ONCOLOGY

Clinical breast cancer

Pub Date : 2026-01-01 DOI: 10.1016/j.clbc.2025.06.002

Charlotte Caroline Hettwer , Georg W. Wurschi , Klaus Pietschmann

Metaplastic breast carcinoma (MBC) is a rare disease for which there is limited evidence from large prospective trials. This systematic review analyzed the characteristics, treatments, and outcomes of MBC patients reported in the literature until October 2024. PubMed and Web of Science were searched systematically for case reports or case series on MBC using predefined search terms according to PRISMA guidelines for systematic reviews (last search: October 2024; registered with Prospero: ID CRD42022356323). Three hundred eighty-four English-language articles (1978-2024) reporting on 491 patients diagnosed with MBC were included.

The median age at diagnosis was 53 years (range, 15-98 years). The median overall survival (OS) was 75.0 months, and median progression-free survival (PFS) was 36.0 ± 13.6 months (standard error). The most frequent locations of recurrence were the lung and local areas.

Univariate analysis revealed that increasing tumor size, publication before the year 2000, lymphadenopathy, metastasis, distant recurrence, and histopathological subtype significantly influenced OS (P < .05). Distant recurrence, metastasis, and year of publication before 2000 were identified as independent predictors of survival through multivariate Cox regression (P < .05).

Tumor size, the proliferation index (Ki-67), and histopathological subtype significantly influenced PFS (P < .05). Adjuvant therapy improved OS and PFS in patients with localized disease (M0) (P < .05).

This is the first systematic analysis of MBC, showing heterogeneous treatment patterns for localized and metastatic disease. Intensive multimodal therapy may improve tumor control and warrants further investigation. The significance of these results is limited by their retrospective nature and the inhomogeneity of single-case reports.

转移性乳腺癌（MBC）是一种罕见的疾病，大型前瞻性试验的证据有限。本系统综述分析了截至2024年10月文献报道的MBC患者的特征、治疗方法和结局。根据PRISMA系统评价指南，系统检索PubMed和Web of Science上的MBC病例报告或病例系列(最后检索时间：2024年10月；在普洛斯彼罗注册：ID CRD42022356323)。纳入了384篇英文文章（1978-2024），报道了491例被诊断为MBC的患者。诊断时的中位年龄为53岁（范围15-98岁）。中位总生存（OS）为75.0个月，中位无进展生存（PFS）为36.0±13.6个月（标准误差）。最常见的复发部位是肺和局部。单因素分析显示，肿瘤大小、2000年前发表、淋巴结病变、转移、远处复发和组织病理学亚型显著影响OS （P < 0.05）。通过多因素Cox回归，发现远处复发、转移和发表年份在2000年之前是独立的生存预测因素（P < 0.05）。肿瘤大小、增殖指数（Ki-67）和组织病理学亚型对PFS有显著影响（P < 0.05）。辅助治疗可改善局限性疾病患者的OS和PFS (M0) （P < 0.05）。这是对MBC的首次系统分析，显示了局部和转移性疾病的不同治疗模式。强化多模式治疗可改善肿瘤控制，值得进一步研究。这些结果的意义受限于它们的回顾性和单例报告的不同质性。

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引用次数: 0

The Role of Adjuvant Radiation Therapy in Treating Older Breast Cancer Patients With Low Adherence to Endocrine Therapy 辅助放射治疗在内分泌治疗依从性低的老年乳腺癌患者中的作用。

IF 2.5 3区医学 Q2 ONCOLOGY

Clinical breast cancer

Pub Date : 2026-01-01 DOI: 10.1016/j.clbc.2025.07.028

M. Judy Lubas , Jill Hasler , Jordan Fredette , Ana Sandoval-Leon , Richard J. Bleicher , Austin D. Williams , Lindsey Taylor , Joshua E. Meyer , Rebecca M. Shulman

Background

Older patients with hormone receptor-positive, human epidermal growth factor receptor 2 (HER2)-negative early-stage breast cancer (HPEsBC) typically undergo breast-conserving surgery (BCS) followed by adjuvant radiation therapy (RT) and/or endocrine therapy (ET). Our study aimed to identify predictors of low ET adherence and evaluate the role of RT in modifying survival among patients with low ET adherence.

Methods

A retrospective analysis was performed using a US-based, electronic health record-derived, de-identified database. Patients aged ≥65 years with HPEsBC treated with BCS from 2011 to 2018 were included. Four adjuvant treatment groups were identified. Low ET adherence was defined as ET use for <80% of the 5-year post surgery follow-up period. Multinomial logistic regression was used to identify predictors of low adherence. Survival outcomes were assessed using hazard ratios (HRs) adjusted for covariates.

Results

A total of 1,488 patients were included in the study. Among patients receiving ET, 23% demonstrated low adherence. After adjustment for covariates, mortality was higher for RT alone (HR = 1.79, p = .011) and no adjuvant therapy (HR = 2.65, p < .001) compared with ET + RT. Predictors of low ET adherence included increasing age (odds ratio [OR] = 1.06, p < .010) and treatment at an academic practice (OR = 2.58, p < .001). A 10% decline in ET adherence was associated with increased mortality (HR = 1.17, p < .001). An interaction analysis revealed no differential effect of RT in the context of ET adherence.

Conclusion

Low ET adherence occurred in approximately one-quarter of patients and was associated with advancing age and treatment at academic centers. Reduced ET adherence was linked to significantly increased mortality. Further investigation into the role of RT in patients with low ET adherence is warranted.

背景：激素受体阳性，人表皮生长因子受体2 （HER2）阴性的早期乳腺癌（HPEsBC）的老年患者通常接受保乳手术（BCS），然后进行辅助放射治疗（RT）和/或内分泌治疗（ET）。我们的研究旨在确定低ET依从性的预测因素，并评估RT在改善低ET依从性患者生存中的作用。方法：使用基于美国的电子健康记录衍生的去识别数据库进行回顾性分析。纳入2011年至2018年接受BCS治疗的年龄≥65岁的HPEsBC患者。确定了四个辅助治疗组。低ET依从性被定义为ET使用的结果：共有1488名患者纳入研究。在接受ET治疗的患者中，23%表现出低依从性。调整协变量后，与ET + RT相比，单独RT组（HR = 1.79, p = 0.011）和无辅助治疗组（HR = 2.65, p < 0.001）的死亡率更高。低ET依从性的预测因素包括年龄增加（优势比[OR] = 1.06, p < 0.010）和学术实践治疗（OR = 2.58, p < 0.001）。ET依从性下降10%与死亡率增加相关（HR = 1.17, p < 0.001）。相互作用分析显示，在ET依从性的背景下，RT没有差异效应。结论：低ET依从性发生在大约四分之一的患者中，并且与年龄的增长和学术中心的治疗有关。降低ET依从性与死亡率显著增加有关。进一步研究RT在低ET依从性患者中的作用是必要的。

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引用次数: 0

Appropriate Treatment for Stage 1 and 2 Her2-Positive and Triple-Negative Breast Cancer by Immigration Status in Ontario, Canada 加拿大安大略省移民身份对1期和2期her2阳性和三阴性乳腺癌的适当治疗

IF 2.5 3区医学 Q2 ONCOLOGY

Clinical breast cancer

Pub Date : 2026-01-01 DOI: 10.1016/j.clbc.2025.07.013

Omolara Fatiregun , Rinku Sutradhar , Sho Podolsky , Andrea Eisen , Lawrence Paszat , Eileen Rakovitch

Purpose

This study explored appropriate treatment received for stage 1 and 2 Her2-positive and triple-negative (TN) breast cancer (BC) among immigrants and long-term residents.

Methods

We identified women aged 18- 75 years diagnosed with BC in Ontario from 2012 to 2019. We stratified them into immigrants and long-term residents using the Immigration, Refugee, and Citizenship Canada Permanent Resident database (CIC). We linked to population-wide treatment databases to extract information on breast surgery, chemotherapy, and radiotherapy. We categorized them into 4 mutually exclusive groups based on subtype (Her-2 positive or TNBC) and breast surgery (breast-conserving surgery (BCS) vs. mastectomy). Appropriate treatment included chemotherapy for all (plus Herceptin if Her-2 overexpressing), plus breast radiation therapy if breast-conserving surgery was performed. We could not assess the receipt of endocrine therapy for the hormone receptor-positive subset of Her-2 overexpressors, or indications for postmastectomy radiation therapy. Odds ratios for receiving appropriate treatment were calculated using logistic regression, adjusting for age, resource utilization and area-level residential ethnicity concentration.

Results

Crude and univariate analyses showed no differences in the receipt of appropriate treatment. Similarly, adjusted analyses in each of the 4 subgroups showed no difference between immigrants and long-term residents. Among Her2-positive treated by(BCS) group,(Odds Ratio[OR] = 0.82, 95% Confidence Interval[CI] 0.65-1.03, and treated by mastectomy, OR = 0.95 (95% CI, 0.67-1.35). Among TNBC treated by BCS, OR = 0.81 (95% CI, 0.58-1.13), and treated by mastectomy,OR 0.85 (95% CI, 0.49-1.46).

Conclusion

Immigration status was not associated with the receipt of appropriate treatment amongst early-stage Her2-positive or TNBC breast cancer in Ontario.

目的：本研究探讨移民和长期居民中1期和2期her2阳性和三阴性（TN）乳腺癌（BC）的适当治疗方法。方法：我们选取了2012年至2019年在安大略省诊断为BC的18- 75岁女性。我们使用加拿大移民、难民和公民身份永久居民数据库（CIC）将他们分为移民和长期居民。我们连接到人口范围的治疗数据库，提取有关乳房手术、化疗和放疗的信息。我们根据亚型（Her-2阳性或TNBC）和乳房手术（保乳手术（BCS） vs乳房切除术）将其分为4个相互排斥的组。适当的治疗包括所有患者的化疗（如果Her-2过表达，则加用赫赛汀），如果进行保乳手术，则加用乳房放射治疗。我们无法评估Her-2过表达者中激素受体阳性亚群接受内分泌治疗的情况，也无法评估乳房切除术后放射治疗的适应症。使用逻辑回归计算接受适当治疗的优势比，调整年龄、资源利用和地区水平居住种族浓度。结果：粗分析和单因素分析显示，在接受适当治疗方面没有差异。同样，在4个亚组中进行的调整分析显示，移民和长期居民之间没有差异。在her2阳性（BCS）组中，（优势比[OR] = 0.82, 95%可信区间[CI] 0.65-1.03），(OR] = 0.95 （95% CI, 0.67-1.35）。在接受BCS治疗的TNBC中，OR = 0.81 (95% CI, 0.58-1.13)，而接受乳房切除术治疗的TNBC，OR = 0.85 （95% CI, 0.49-1.46）。结论：安大略省早期her2阳性或TNBC乳腺癌患者的移民身份与接受适当治疗无关。

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引用次数: 0

The Effects of Compression Therapy at Different Pressure Levels on Chemotherapy-Induced Peripheral Neuropathy in Breast Cancer Patients: A Randomized Controlled Trial 不同压力水平的压迫治疗对乳腺癌化疗诱导的周围神经病变的影响：一项随机对照试验。

IF 2.5 3区医学 Q2 ONCOLOGY

Clinical breast cancer

Pub Date : 2026-01-01 DOI: 10.1016/j.clbc.2025.08.009

Hong Li , Yijing Fan , Huiqian Xu , Haihong Qu , Yang Wang , Dandan Yu , Lizhi Zhou

Purpose

This study aims to examine the effects of compression therapy at different pressure levels on chemotherapy-induced peripheral neuropathy (CIPN).

Methods

A total of 108 breast cancer patients who developed CIPN after their first albumin-bound paclitaxel chemotherapy were randomly divided into 3 groups(1:1:1): control group, experimental group 1 (Grade II pressure: 23-32 mmHg), and experimental group 2 (Grade III pressure: 34-46 mmHg). The control group was given standard care, while the experimental groups underwent compression therapy in addition to standard care. CIPN incidence, symptom severity, and its impact on activities of daily living (ADL) were assessed at baseline, after the completion of the third and fifth chemotherapy cycles.

Results

After completing 3 chemotherapy cycles, CIPN incidence did not differ significantly among the groups (P > .05). After 5 cycles, the incidence of CIPN (≥ Grade 1) was significantly lower in both experimental groups compared to the control group (P < .05), with Experimental Group 2 also showing lower CIPN incidence (≥ Grade 2) than the control and Experimental Group 1 (P < .05). Both Grade II and III compression therapies alleviated CIPN symptoms and improved ADL, but Experimental Group 2 demonstrated superior efficacy after 5 cycles (P < .05). Significant differences in symptom severity and ADL impact were observed across group, time, and interaction effects (P < .001).

Conclusion

Compression therapy reduces CIPN incidence, alleviates symptoms, and improves ADL. Over longer intervention periods, Grade III pressure yields superior outcomes.

目的：本研究旨在探讨不同压力水平的压迫治疗对化疗诱导的周围神经病变（CIPN）的影响。方法：将首次白蛋白结合紫杉醇化疗后发生CIPN的乳腺癌患者108例随机分为3组（1:1:1）：对照组、实验1组（II级压力：23-32 mmHg）、实验2组（III级压力：34-46 mmHg）。对照组给予标准治疗，实验组在标准治疗的基础上进行压迫治疗。在完成第三和第五个化疗周期后，基线时评估CIPN发生率、症状严重程度及其对日常生活活动（ADL）的影响。结果：完成3个化疗周期后，各组间CIPN发生率无显著差异（P < 0.05）。5个疗程后，两组患者CIPN（≥1级）发生率均显著低于对照组（P < 0.05），且实验组2 CIPN（≥2级）发生率均低于对照组和实验组1 （P < 0.05）。II级和III级压缩治疗均能减轻CIPN症状，改善ADL，但实验2组在5个周期后疗效更优（P < 0.05）。症状严重程度和ADL影响在组间、时间和相互作用方面存在显著差异（P < 0.001）。结论：压迫治疗可降低CIPN发生率，减轻症状，改善ADL。在较长的干预时间内，III级压力效果更好。

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引用次数: 0

Re: Bridging Gaps in Remote Cancer Care: Commentary on the Adjuvant Abemaciclib Monitoring Model 关于：弥合远程癌症治疗的差距：对辅助Abemaciclib监测模型的评论。

IF 2.5 3区医学 Q2 ONCOLOGY

Clinical breast cancer

Pub Date : 2026-01-01 DOI: 10.1016/j.clbc.2025.08.005

Nicole L. Brown , Ann Tivey , Caroline Wilson , Fiona Britton , Sacha J. Howell

引用次数: 0

The USP8/CEP55/CHMP6 Axis Orchestrates Triple-Negative Breast Cancer Progression by Regulating Ferroptosis and Macrophage M2 Polarization USP8/CEP55/CHMP6轴通过调节铁凋亡和巨噬细胞M2极化来协调三阴性乳腺癌的进展。

IF 2.5 3区医学 Q2 ONCOLOGY

Clinical breast cancer

Pub Date : 2026-01-01 DOI: 10.1016/j.clbc.2025.08.003

Lin Wang , Ye Wang , Changgen Liu , Yixin Zhao

Background

Triple-negative breast cancer (TNBC) carries a substantial risk of recurrence and metastasis, posing significant threats to patients’ health and quality of life. Centrosomal protein 55 (CEP55) has been demonstrated to exhibit elevated expression levels in TNBC. However, its molecular regulatory mechanism in TNBC remains unclear.

Methods

Bioinformatics databases, qRT-PCR, and Western blot were employed to analyze CEP55 expression in TNBC tissues and cells. EdU assays, flow cytometry, and Transwell assays were utilized to monitor cell proliferation, apoptosis, and invasion. Subsequently, macrophage polarization was detected by flow cytometry. Fe²⁺, malondialdehyde (MDA), glutathione (GSH), and reactive oxygen species (ROS) levels were determined using corresponding kits. Immunoprecipitation (IP) was used to detect the ubiquitination level of CEP55, and co-IP was applied to confirm the interaction between CEP55 and Charged Multivesicular Body Protein 6 (CHMP6). Finally, a xenograft tumor model was established, and immunohistochemistry (IHC) was conducted to evaluate the expression of specific proteins.

Results

CEP55 levels were increased in TNBC tissues and cells. Silencing CEP55 repressed TNBC cell proliferation, invasion, and macrophage M2 polarization, and facilitated cell apoptosis and ferroptosis. Additionally, ubiquitin-specific protease 8 (USP8) maintained CEP55 stability through deubiquitination, and CEP55 overexpression reversed the cellular effects caused by USP8 knockdown. Moreover, CEP55 bound to CHMP6 to promote its expression, thereby facilitating the malignant progression of TNBC cells. CEP55 overexpression abolished the inhibitory influence of USP8 silencing on tumor growth in vivo.

Conclusion

USP8 stabilized CEP55 expression through deubiquitination, and CEP55 further promoted CHMP6 expression to inhibit ferroptosis progression, thereby facilitating macrophage M2 polarization and malignant biological behaviors of TNBC cells.

背景：三阴性乳腺癌（TNBC）具有很大的复发和转移风险，对患者的健康和生活质量构成重大威胁。中心体蛋白55 （CEP55）已被证实在TNBC中表达水平升高。然而，其在TNBC中的分子调控机制尚不清楚。方法：采用生物信息学数据库、qRT-PCR和Western blot技术分析CEP55在TNBC组织和细胞中的表达。EdU法、流式细胞术、Transwell法监测细胞增殖、凋亡和侵袭。随后用流式细胞术检测巨噬细胞极化。采用相应试剂盒检测Fe2+、丙二醛（MDA）、谷胱甘肽（GSH）、活性氧（ROS）水平。采用免疫沉淀法（Immunoprecipitation， IP）检测CEP55的泛素化水平，采用协同沉淀法（co-IP）确定CEP55与带电多泡体蛋白6 （charge Multivesicular Body Protein 6, CHMP6）的相互作用。最后，建立异种移植瘤模型，免疫组化（IHC）评价特异性蛋白的表达。结果：TNBC组织和细胞中CEP55水平升高。沉默CEP55可抑制TNBC细胞增殖、侵袭和巨噬细胞M2极化，促进细胞凋亡和铁死亡。此外，泛素特异性蛋白酶8 （USP8）通过去泛素化维持CEP55的稳定性，并且CEP55过表达逆转了USP8敲低引起的细胞效应。此外，CEP55结合CHMP6促进其表达，从而促进TNBC细胞的恶性进展。在体内，CEP55过表达消除了USP8沉默对肿瘤生长的抑制作用。结论：USP8通过去泛素化作用稳定CEP55的表达，CEP55进一步促进CHMP6的表达，抑制铁凋亡的进展，从而促进TNBC细胞巨噬细胞M2极化和恶性生物学行为。

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引用次数: 0

Bridging Gaps in Remote Cancer Care: Commentary on the Adjuvant Abemaciclib Monitoring Model 弥合远程癌症治疗的差距：对辅助Abemaciclib监测模型的评论。

IF 2.5 3区医学 Q2 ONCOLOGY

Clinical breast cancer

Pub Date : 2026-01-01 DOI: 10.1016/j.clbc.2025.10.005

Javed Iqbal , Brijesh Sathian , Syed Muhammad Ali , Ayesha parvaiz malik

引用次数: 0

Multiomics Analysis for Predicting Pathological Complete Response in Triple-Negative Breast Cancer and Reflecting Tumor Heterogeneity 预测三阴性乳腺癌病理完全缓解和反映肿瘤异质性的多组学分析。

IF 2.5 3区医学 Q2 ONCOLOGY

Clinical breast cancer

Pub Date : 2026-01-01 DOI: 10.1016/j.clbc.2025.08.014

Yufei Wang , Lingfeng Ma , Shijin Yuan , Zhuo Wang , Xian Wang

Background

Heterogeneity in triple-negative breast cancer (TNBC) leads to different responses to neoadjuvant chemotherapy (NAC). NAC-resistant TNBC is often associated with higher risk of recurrence and poor prognosis. This study developed and validated a novel radiomics-based model to predict pathological complete response (pCR) to NAC and reflect tumor heterogeneity in TNBC.

Methods

169 TNBC patients who underwent NAC between 2013 and 2023 were screened as a training cohort. A validation cohort and 2 cohorts containing RNA-seq data were also included. Radiomics features were extracted from dynamic contrast enhanced MRI (DCE-MRI) for model construction. Based on the model, we calculated the radiomics score (Rad-score) of each patient. The predictive capacity of the model was evaluated by area under receiver operating characteristic (ROC) curves. RNA-seq data was used to evaluate drug sensitivity, enriched pathways, and tumor microenvironment (TME) characteristics.

Results

The radiomics model can predict pCR in both the training cohort (AUC = 0.902) and validation cohort (AUC = 0.775). The high Rad-score subgroup exhibited better response to chemotherapy and better prognosis. Immune activation-related pathways were also enriched in the high-score subgroup. The low-score subgroup showed enrichment of TGF-β-related pathways and was more sensitive to TGF-β inhibitor. The model can also identify immune phenotypes (AUC = 0.85). The high Rad-score subgroup had abundant immune cell infiltration, while the low Rad-score subgroup was lacking immune cells in TME.

Conclusion

The model can effectively predict the pCR of TNBC and reflect tumor heterogeneity. Chemotherapy combined with targeting the TGF-β pathway is a potential strategy to overcome drug resistance in TNBC.

背景：三阴性乳腺癌（TNBC）的异质性导致对新辅助化疗（NAC）的不同反应。耐nac的TNBC通常与较高的复发风险和不良预后相关。本研究开发并验证了一种新的基于放射组学的模型，用于预测NAC的病理完全反应（pCR），并反映TNBC中肿瘤的异质性。方法：2013年至2023年间接受NAC治疗的169例TNBC患者作为培训队列进行筛选。还包括一个验证队列和2个包含RNA-seq数据的队列。从动态对比增强MRI （DCE-MRI）中提取放射组学特征用于模型构建。基于该模型，我们计算每位患者的放射组学评分（Rad-score）。用受试者工作特征（ROC）曲线下面积评价模型的预测能力。RNA-seq数据用于评估药物敏感性、富集通路和肿瘤微环境（TME）特征。结果：放射组学模型可以预测训练队列（AUC = 0.902）和验证队列（AUC = 0.775）的pCR。rad评分高的亚组对化疗反应较好，预后较好。在高评分亚组中，免疫激活相关通路也丰富。低评分亚组TGF-β相关通路富集，对TGF-β抑制剂更敏感。该模型还能识别免疫表型（AUC = 0.85）。高评分组免疫细胞浸润丰富，低评分组免疫细胞缺乏。结论：该模型能有效预测TNBC的pCR，反映肿瘤的异质性。化疗联合靶向TGF-β途径是克服TNBC耐药的潜在策略。

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引用次数: 0

Prognostic Outcomes by Axillary Approach in Lobular and Ductal Breast Cancer With Sentinel Node Macrometastases: A Retrospective Cohort Study 腋窝入路治疗前哨淋巴结大转移的小叶和导管乳腺癌的预后：一项回顾性队列研究。

IF 2.5 3区医学 Q2 ONCOLOGY

Clinical breast cancer

Pub Date : 2026-01-01 DOI: 10.1016/j.clbc.2025.07.022

Amparo Garcia-Tejedor , Carla Julià , Julia Ciria , Rodrigo Guevara-Peralta , Carlos Ortega-Expósito , Raul Ortega , Agostina Stradella , Héctor Pérez-Montero , Gabriel Reyes-Juncan , Ana Benitez , Anna Guma , Juan Azcarate , Miriam Campos , Maria J Plà , Evelyn Martinez , Sonia Pernas , Jordi Ponce , Catalina Falo

Purpose

To compare survival outcomes between patients with invasive lobular carcinoma (ILC) and invasive ductal carcinoma non-special type (NST) presenting with sentinel lymph node biopsy (SLNB)-detected macrometastases in early-stage breast cancer.

Materials and Methods

A retrospective cohort study was conducted including 364 cN0 breast cancer patients with SLNB-detected macrometastases who underwent surgical treatment between July 2011 and December 2023. Patients were categorized as NST (n = 250) or ILC (n = 108). SLNB was the primary axillary staging procedure, with axillary lymph node dissection (ALND) performed according to predefined clinical criteria. Univariate and multivariate Cox regression analyses were used to identify predictors of pN2–pN3. Survival outcomes were assessed using Kaplan-Meier curves and compared with log-rank tests.

Results

ILC patients presented with larger tumors, higher rates of multifocality, and greater axillary nodal involvement compared to NST. Surgery was more frequently mastectomy and ALND. pN2-N3 was identified in 12% of cases, with pT3 stage, ILC histology, and lymphovascular invasion as independent predictors. After a median follow-up of 7.6 years, the ILC group exhibited higher overall mortality (19.4% vs. 9.6%) and deaths attributed to systemic progression (57% vs. 29%). Ten-year distant disease-free survival and breast cancer-specific survival were significantly lower in the ILC cohort (63% vs. 87% and 65% vs. 93%, respectively; P < .05). Although 10-year overall survival was lower in ILC (54% vs. 79%), statistical significance was only observed in patients with advanced nodal disease (pN2–N3).

Conclusions

ILC is associated with more advanced axillary burden and significantly worse long-term oncologic outcomes compared to NST carcinoma when macrometastases are present at SLNB.

目的：比较浸润性小叶癌（ILC）和浸润性导管癌（NST）患者在早期乳腺癌中前哨淋巴结活检（SLNB）检测到的大转移的生存结果。材料与方法：对2011年7月至2023年12月接受手术治疗的364例cN0乳腺癌slnb大转移灶患者进行回顾性队列研究。患者分为NST组（n = 250）和ILC组（n = 108）。SLNB是主要的腋窝分期程序，根据预先确定的临床标准进行腋窝淋巴结清扫（ALND）。采用单因素和多因素Cox回归分析确定pN2-pN3的预测因子。生存结果采用Kaplan-Meier曲线进行评估，并与log-rank检验进行比较。结果：与NST相比，ILC患者表现为更大的肿瘤，更高的多发灶率和更大的腋窝淋巴结受累。手术更常见的是乳房切除术和ALND。12%的病例中发现pN2-N3， pT3分期、ILC组织学和淋巴血管侵袭是独立的预测因素。在中位随访7.6年后，ILC组表现出更高的总死亡率（19.4%对9.6%）和归因于全身进展的死亡率（57%对29%）。ILC组的10年远期无病生存率和乳腺癌特异性生存率显著降低（分别为63%对87%和65%对93%，P < 0.05）。尽管ILC患者的10年总生存率较低（54%对79%），但仅在晚期淋巴结疾病（pN2-N3）患者中观察到统计学意义。结论：与NST癌相比，当SLNB存在巨转移时，ILC与更晚期的腋窝负担相关，且长期肿瘤预后明显更差。

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引用次数: 0

Minimal Clinically Important Differences in Scales Measuring Decision Uncertainty, Distress After a Traumatic Event, Body Image and Health Status Among Women With Breast Cancer Having Surgery 乳腺癌手术妇女的决策不确定性、创伤事件后的痛苦、身体形象和健康状况量表的最小临床重要差异

IF 2.5 3区医学 Q2 ONCOLOGY

Clinical breast cancer

Pub Date : 2026-01-01 DOI: 10.1016/j.clbc.2025.07.021

Britt A M Jansen , Claudia A Bargon , Danny A Young-Afat , Annemiek Doeksen , Teun Teunis

Background

The smallest clinically relevant change (ie, minimal clinically important difference, MCID) for several valuable PROMs for women undergoing breast cancer surgery is unknown. Therefore, this study evaluated the smallest clinically relevant change for decision uncertainty, distress after traumatic events, body image, and health status in women diagnosed with breast cancer considering surgery.

Patients and methods

Between August 2020 and October 2022, we included 123 women with breast cancer considering surgical treatment. Women completed the decisional conflict scale (DCS), impact of event scale (IES), body image scale (BIS), and 36-Item Short Form (SF-36) after their first visit, and 4-6 weeks and 6 months after surgery. The MCID was calculated using the anchor-based method. For the MCID to be reliable, it needs to be greater than the minimum detectable change (MDC).

Results

The MCID for decision uncertainty (8.6) was smaller than the MDC (22). MCID values were 11 and 12 (MDC 8.4) for improvement in cancer-specific distress (IES), 2.5 and 6.5 (MDC 2.6) for deterioration in body image (BIS) and 27 and 14 (MDC 12) for deterioration in health status (SF-36) at 4 to 6 weeks and 6 months after surgery, respectively.

Conclusion

This study successfully determined MCIDs for several PROMs. For IES, BIS, and SF-36 the MCID seems reliable, while the DCS cannot reliably capture a clinically relevant change. The MCID values may be useful when assessing clinically relevant changes over time, interpreting treatment effects, and trial sample size determination.

背景：在接受乳腺癌手术的女性中，几个有价值的PROMs的最小临床相关变化（即最小临床重要差异，MCID）是未知的。因此，本研究评估了考虑手术的乳腺癌患者在决策不确定性、创伤事件后痛苦、身体形象和健康状况方面最小的临床相关变化。患者和方法：在2020年8月至2022年10月期间，我们纳入了123名考虑手术治疗的乳腺癌女性。女性在首次就诊后、术后4-6周和6个月分别完成决策冲突量表（DCS）、事件影响量表（IES）、身体形象量表（BIS）和36项简短表格（SF-36）。MCID采用锚定法计算。为了使MCID可靠，它需要大于最小可检测变化（最小可检测变化MDC）。结果：决策不确定性的MCID（8.6）小于MDC（22）。术后4 ~ 6周和6个月，癌症特异性痛苦（IES）改善的MCID值分别为11和12 (MDC 8.4)，身体形象（BIS）恶化的MCID值分别为2.5和6.5 (MDC 2.6)，健康状况（SF-36）恶化的MCID值分别为27和14 （MDC 12）。结论：本研究成功地测定了几种PROMs的MCIDs。对于IES、BIS和SF-36， MCID似乎是可靠的，而DCS不能可靠地捕捉临床相关的变化。在评估临床相关变化、解释治疗效果和确定试验样本量时，MCID值可能是有用的。

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引用次数: 0