This study conducted to assess the knowledge, perceptions, attitudes, and barriers toward breast reconstruction (BR) among women who underwent mastectomy for a breast cancer primary and identify predictors of BR uptake.
Methods
A cross-sectional study was conducted at KHCC. Data were collected using a structured Arabic questionnaire. The questionnaire covered demographics, clinical background, knowledge, attitudes, and perceived barriers. Descriptive statistics, Chi-square tests, and multivariate regression models were used to analyze predictors of BR uptake.
Results
Of the 603 participants (mean age 49.5 years), 50.3% had undergone BR. Uptake was significantly higher among younger women (P < .001), those employed (P = .002), with higher education levels (P < .001), no chronic illness (P = .03), and premenopausal status (P = .001). While 70.8% had received BR information from physicians, 58.2% were unaware of BR before their diagnosis. Implants were more commonly recognized (87.2%) compared to autologous methods (39.5%). Though 69% believed BR improves quality of life, 72% viewed it as cosmetic rather than medically necessary. Regression analysis showed that younger age (OR = 0.94), employment (OR = 2.19), higher knowledge (OR = 1.29), and positive attitudes (OR = 1.25) significantly predicted BR uptake. Among those who had not undergone BR, barriers included fear of surgery (50%), misinformation, lack of interest, and financial constraints (39.5).
Conclusion
Despite clinical advancements, BR remains underutilized in Jordan due to knowledge gaps, limited counseling, and sociocultural misconceptions. Empowering patients through targeted education, integrating BR into oncologic care pathways, and enhancing provider communication are warranted to ensure equitable, informed, and holistic breast cancer survivorship.
{"title":"Knowledge, Awareness, Perceptions, and Attitudes Toward Breast Reconstruction Among Breast Cancer Women in Jordan: A Cross-Sectional Study","authors":"Saleh Abualhaj , Lina Alshadfan , Mosleh M. Abualhaj , Yasmin Safi , Mohammad Al-Share , Huda Alzagatit , Aseel Qandil , Tamara Abdalkader , Weam Sowan , Younis Hizzani , Zain aldeen Saleh , Yousef Albustanji , Mahmoud Al-Masri","doi":"10.1016/j.clbc.2025.12.008","DOIUrl":"10.1016/j.clbc.2025.12.008","url":null,"abstract":"<div><h3>Purpose</h3><div>This study conducted to assess the knowledge, perceptions, attitudes, and barriers toward breast reconstruction (BR) among women who underwent mastectomy for a breast cancer primary and identify predictors of BR uptake.</div></div><div><h3>Methods</h3><div>A cross-sectional study was conducted at KHCC. Data were collected using a structured Arabic questionnaire. The questionnaire covered demographics, clinical background, knowledge, attitudes, and perceived barriers. Descriptive statistics, Chi-square tests, and multivariate regression models were used to analyze predictors of BR uptake.</div></div><div><h3>Results</h3><div>Of the 603 participants (mean age 49.5 years), 50.3% had undergone BR. Uptake was significantly higher among younger women (<em>P</em> < .001), those employed (<em>P</em> = .002), with higher education levels (<em>P</em> < .001), no chronic illness (<em>P</em> = .03), and premenopausal status (<em>P</em> = .001). While 70.8% had received BR information from physicians, 58.2% were unaware of BR before their diagnosis. Implants were more commonly recognized (87.2%) compared to autologous methods (39.5%). Though 69% believed BR improves quality of life, 72% viewed it as cosmetic rather than medically necessary. Regression analysis showed that younger age (OR = 0.94), employment (OR = 2.19), higher knowledge (OR = 1.29), and positive attitudes (OR = 1.25) significantly predicted BR uptake. Among those who had not undergone BR, barriers included fear of surgery (50%), misinformation, lack of interest, and financial constraints (39.5).</div></div><div><h3>Conclusion</h3><div>Despite clinical advancements, BR remains underutilized in Jordan due to knowledge gaps, limited counseling, and sociocultural misconceptions. Empowering patients through targeted education, integrating BR into oncologic care pathways, and enhancing provider communication are warranted to ensure equitable, informed, and holistic breast cancer survivorship.</div></div>","PeriodicalId":10197,"journal":{"name":"Clinical breast cancer","volume":"26 2","pages":"Pages 59-69"},"PeriodicalIF":2.5,"publicationDate":"2025-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146035521","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-29DOI: 10.1016/j.clbc.2025.12.009
Jennifer D Brooks, Kristina M Blackmore, Nguyet N M Ngo, Meghan J Walker, Amy Chang, Laurence Lambert-Côté, Annie Turgeon, Aisha K Lofters, Hermann Nabi, Antonis C Antoniou, Kathleen A Bell, Mireille J M Broeders, Tim Carver, Jocelyne Chiquette, Philippe Després, Douglas F Easton, Andrea Eisen, Laurence Eloy, D Gareth Evans, Samantha Fienberg, Yann Joly, Raymond H Kim, Shana J Kim, Bartha M Knoppers, Jean-Sebastien Paquette, Nora Pashayan, Amanda J Sheppard, Tracy L Stockley, Michel Dorval, Jacques Simard, Anna M Chiarelli
Background: Risk-stratified breast cancer screening has been proposed as an alternative to the age-based approach currently used by most screening programs. This study, part of the Canadian PERSPECTIVE I&I project, examined perceived advantages and disadvantages of learning your breast cancer risk category and associated screening plans.
Method: Women aged 40 to 69 from Ontario and Quebec (N = 3319) had multifactorial risk assessments using the CanRisk tool. Risk categories (average [78.9%], higher than average [16.4%], high [4.6%]) were communicated along with screening plans. Participants completed questionnaires on attitudes toward learning their risk before, at the time of, and 1 year later risk communication. Participant characteristics associated with these attitudes were assessed using multinomial logistic regression.
Results: At the time of risk communication, most participants (72.9%) perceived ``Easing worry'' as an advantage of learning their risk. However, participants at higher risk were more likely to report that it did not ease their worry. Visible minority participants (OR = 1.86, 95% CI, 1.16, 2.98) and those with lower education attainment were more likely to view "complicated information" as a disadvantage (College/Apprenticeship/Trades: OR = 1.54, 95% CI, 1.24, 1.92; High School or below: OR = 1.77, 95% CI, 1.29, 2.42). Ontario participants were more likely to view risk communication as "information I do not want to know" (OR = 0.44, 95% CI, 0.32, 0.59) compared to Quebec participants.
Conclusion: Most women responded positively to learning their breast cancer risk category and screening plan. Successful implementation of risk-stratified screening will require clear communication, healthcare provider support, and adaptation to regional resources.
{"title":"Canadian Women's Attitudes Toward Receiving Personalized Breast Cancer Risk Information: Insights From the PERSPECTIVE I&I Project.","authors":"Jennifer D Brooks, Kristina M Blackmore, Nguyet N M Ngo, Meghan J Walker, Amy Chang, Laurence Lambert-Côté, Annie Turgeon, Aisha K Lofters, Hermann Nabi, Antonis C Antoniou, Kathleen A Bell, Mireille J M Broeders, Tim Carver, Jocelyne Chiquette, Philippe Després, Douglas F Easton, Andrea Eisen, Laurence Eloy, D Gareth Evans, Samantha Fienberg, Yann Joly, Raymond H Kim, Shana J Kim, Bartha M Knoppers, Jean-Sebastien Paquette, Nora Pashayan, Amanda J Sheppard, Tracy L Stockley, Michel Dorval, Jacques Simard, Anna M Chiarelli","doi":"10.1016/j.clbc.2025.12.009","DOIUrl":"https://doi.org/10.1016/j.clbc.2025.12.009","url":null,"abstract":"<p><strong>Background: </strong>Risk-stratified breast cancer screening has been proposed as an alternative to the age-based approach currently used by most screening programs. This study, part of the Canadian PERSPECTIVE I&I project, examined perceived advantages and disadvantages of learning your breast cancer risk category and associated screening plans.</p><p><strong>Method: </strong>Women aged 40 to 69 from Ontario and Quebec (N = 3319) had multifactorial risk assessments using the CanRisk tool. Risk categories (average [78.9%], higher than average [16.4%], high [4.6%]) were communicated along with screening plans. Participants completed questionnaires on attitudes toward learning their risk before, at the time of, and 1 year later risk communication. Participant characteristics associated with these attitudes were assessed using multinomial logistic regression.</p><p><strong>Results: </strong>At the time of risk communication, most participants (72.9%) perceived ``Easing worry'' as an advantage of learning their risk. However, participants at higher risk were more likely to report that it did not ease their worry. Visible minority participants (OR = 1.86, 95% CI, 1.16, 2.98) and those with lower education attainment were more likely to view \"complicated information\" as a disadvantage (College/Apprenticeship/Trades: OR = 1.54, 95% CI, 1.24, 1.92; High School or below: OR = 1.77, 95% CI, 1.29, 2.42). Ontario participants were more likely to view risk communication as \"information I do not want to know\" (OR = 0.44, 95% CI, 0.32, 0.59) compared to Quebec participants.</p><p><strong>Conclusion: </strong>Most women responded positively to learning their breast cancer risk category and screening plan. Successful implementation of risk-stratified screening will require clear communication, healthcare provider support, and adaptation to regional resources.</p>","PeriodicalId":10197,"journal":{"name":"Clinical breast cancer","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-12-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146123890","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-22DOI: 10.1016/j.clbc.2025.12.004
Jacopo Nori Cucchiari , Federica Di Naro , Giuliano Migliaro , Sofia Elisabetta Baldi Giorgi , Francesca Pugliese , Tommaso Amadori , Giulia Bicchierai , Diego De Benedetto , Chiara Bellini , Sofia Vidali , Ermanno Vanzi , Cecilia Boeri , Verdiana Lamagna , Vittorio Miele , Tommaso Susini
Background
Breast cancer (BC) is the most common cancer among women. There has been growing interest in less invasive techniques for the treatment of breast lesions, with cryoablation emerging as promising option. We aimed to assess the safety and efficacy of cryoablation for the treatment of breast cancer tumor subtypes 12 months post-treatment.
Methods
This single-center prospective study included patients with biopsy-proven BC who underwent ultrasound-guided-cryoablation treatment during 2021-2023. Locoregional staging was performed using ultrasound and contrast-enhanced mammography (CEM). Follow-up included ultrasound at 1-, 3-, 6- and 12-months with additional CEM and biopsy at 12-months. Rate of complete ablation, tumor size and quality of life (QoL) were assessed. Primary endpoint was absence of residual tumor for BC at 12-month post cryoablation.
Results
Thirthy-six female patients (mean age, 84.5±6.7 years) with 39 biopsy-proven tumors (mean size 15.3±7.5 mm) underwent cryoablation. No device-related unexpected adverse events were reported. The 39 BCs were early-stage luminal A or B, invasive ductal carcinoma (IDC) or IDC + ductal carcinoma in situ. Complete ablation rates for BC ≤ 15 mm and BC >15 mm were 100% and 84.6%, respectively; Cryoablation positively impacted patient QoL as assessed by validated questionnaires.
Conclusions
With improved QoL, cryoablation emerges as a promising, safe, and effective treatment option for low-risk breast cancer.
Disclaimer/Publisher’s Note
The statements, opinions and data contained in all publications are solely those of the individual author(s) and contributor(s) and not of MDPI and/or the editor(s). MDPI and/or the editor(s) disclaim responsibility for any injury to people or property resulting from any ideas, methods, instructions or products referred to in the content.
{"title":"Cryoablation for Treatment of Early-Stage Breast Cancer: Efficacy and Quality of Life Assessment","authors":"Jacopo Nori Cucchiari , Federica Di Naro , Giuliano Migliaro , Sofia Elisabetta Baldi Giorgi , Francesca Pugliese , Tommaso Amadori , Giulia Bicchierai , Diego De Benedetto , Chiara Bellini , Sofia Vidali , Ermanno Vanzi , Cecilia Boeri , Verdiana Lamagna , Vittorio Miele , Tommaso Susini","doi":"10.1016/j.clbc.2025.12.004","DOIUrl":"10.1016/j.clbc.2025.12.004","url":null,"abstract":"<div><h3>Background</h3><div>Breast cancer (BC) is the most common cancer among women. There has been growing interest in less invasive techniques for the treatment of breast lesions, with cryoablation emerging as promising option. We aimed to assess the safety and efficacy of cryoablation for the treatment of breast cancer tumor subtypes 12 months post-treatment.</div></div><div><h3>Methods</h3><div>This single-center prospective study included patients with biopsy-proven BC who underwent ultrasound-guided-cryoablation treatment during 2021-2023. Locoregional staging was performed using ultrasound and contrast-enhanced mammography (CEM). Follow-up included ultrasound at 1-, 3-, 6- and 12-months with additional CEM and biopsy at 12-months. Rate of complete ablation, tumor size and quality of life (QoL) were assessed. Primary endpoint was absence of residual tumor for BC at 12-month post cryoablation.</div></div><div><h3>Results</h3><div>Thirthy-six female patients (mean age, 84.5±6.7 years) with 39 biopsy-proven tumors (mean size 15.3±7.5 mm) underwent cryoablation. No device-related unexpected adverse events were reported. The 39 BCs were early-stage luminal A or B, invasive ductal carcinoma (IDC) or IDC + ductal carcinoma in situ. Complete ablation rates for BC ≤ 15 mm and BC >15 mm were 100% and 84.6%, respectively; Cryoablation positively impacted patient QoL as assessed by validated questionnaires.</div></div><div><h3>Conclusions</h3><div>With improved QoL, cryoablation emerges as a promising, safe, and effective treatment option for low-risk breast cancer.</div></div><div><h3>Disclaimer/Publisher’s Note</h3><div>The statements, opinions and data contained in all publications are solely those of the individual author(s) and contributor(s) and not of MDPI and/or the editor(s). MDPI and/or the editor(s) disclaim responsibility for any injury to people or property resulting from any ideas, methods, instructions or products referred to in the content.</div></div>","PeriodicalId":10197,"journal":{"name":"Clinical breast cancer","volume":"26 2","pages":"Pages 70-79"},"PeriodicalIF":2.5,"publicationDate":"2025-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146035567","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-20DOI: 10.1016/j.clbc.2025.12.005
Iva M. Borisova Boyanova , Lidia Blay Aulina , Marta de la Iglésia , David López-Cano , Cristina Serra-Serra , Neus Ruiz-Edo , Maite Salcedo-Pujantell , Juan Francisco Julián Ibañéz , Sandra López Gordo
Background
Sentinel lymph node biopsy (SLNB) using Technetium-99 (Tc-99) is the standard technique for axillary staging in breast cancer. However, it has logistic issues, especially in hospitals without a nuclear medicine department (NMD). As the sensitivity and specificity of indocyanine green (ICG) are comparable to those of Tc-99, the aim of this study was to perform a cost-benefit analysis of the 2 methods.
Materials and Methods
A prospective observational cohort of patients undergoing breast cancer surgery was included. Tc-99 and ICG were administered during the same procedure for SLNB. Three clinical pathways were constructed: Tc-99 administration at hospitals without NMD (first clinical pathway), Tc-99 administration at hospitals with NMD (second), and the ICG method (third). A cost comparison between the pathways was performed using the monetary unit of Euros (€).
Results
Between April 2021 and April 2024, 112 patients with breast cancer underwent SLNB using Tc-99 and ICG detection. The total cost per patient for the first clinical pathway was €322.29, for the second, €308.29 and for the third, €61.35 per patient. The cumulative cost for 112 patients in the first and second clinical pathways (€37,216.48 and €34,528.48, respectively) resulted to be 5.2 times the cost of the ICG pathway (€6871.2). The use of ICG results in an average saving of approximately 80% of the Tc-99 expenses.
Conclusion
ICG is a cost-effective option as a tracer for sentinel lymph node biopsy in breast cancer. ICG also offers logistic advantages and it should be considered in clinical practice and protocols.
{"title":"Cost Analysis of Technetium-99m versus Indocyanine Green for Sentinel Lymph Node Biopsy in Breast Cancer","authors":"Iva M. Borisova Boyanova , Lidia Blay Aulina , Marta de la Iglésia , David López-Cano , Cristina Serra-Serra , Neus Ruiz-Edo , Maite Salcedo-Pujantell , Juan Francisco Julián Ibañéz , Sandra López Gordo","doi":"10.1016/j.clbc.2025.12.005","DOIUrl":"10.1016/j.clbc.2025.12.005","url":null,"abstract":"<div><h3>Background</h3><div>Sentinel lymph node biopsy (SLNB) using Technetium-99 (Tc-99) is the standard technique for axillary staging in breast cancer. However, it has logistic issues, especially in hospitals without a nuclear medicine department (NMD). As the sensitivity and specificity of indocyanine green (ICG) are comparable to those of Tc-99, the aim of this study was to perform a cost-benefit analysis of the 2 methods.</div></div><div><h3>Materials and Methods</h3><div>A prospective observational cohort of patients undergoing breast cancer surgery was included. Tc-99 and ICG were administered during the same procedure for SLNB. Three clinical pathways were constructed: Tc-99 administration at hospitals without NMD (first clinical pathway), Tc-99 administration at hospitals with NMD (second), and the ICG method (third). A cost comparison between the pathways was performed using the monetary unit of Euros (€).</div></div><div><h3>Results</h3><div>Between April 2021 and April 2024, 112 patients with breast cancer underwent SLNB using Tc-99 and ICG detection. The total cost per patient for the first clinical pathway was €322.29, for the second, €308.29 and for the third, €61.35 per patient. The cumulative cost for 112 patients in the first and second clinical pathways (€37,216.48 and €34,528.48, respectively) resulted to be 5.2 times the cost of the ICG pathway (€6871.2). The use of ICG results in an average saving of approximately 80% of the Tc-99 expenses.</div></div><div><h3>Conclusion</h3><div>ICG is a cost-effective option as a tracer for sentinel lymph node biopsy in breast cancer. ICG also offers logistic advantages and it should be considered in clinical practice and protocols.</div></div>","PeriodicalId":10197,"journal":{"name":"Clinical breast cancer","volume":"26 2","pages":"Pages 50-58"},"PeriodicalIF":2.5,"publicationDate":"2025-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146028555","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-18DOI: 10.1016/j.clbc.2025.12.002
Aomei Shen , Yuhua Yang , Li Zhang , Nada Lukkahatai , Mei R. Fu , Shengwen Dong , Ying Wang , Hongmeng Zhao , Peipei Wu , Pan Yang , Qian Lu
Background
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).
Methods
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.
Results
The prevalence of lymphatic pain was 18.12% (n = 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 P < .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 (P = .032). Predicted probabilities indicated that obesity had minimal effect among participants without BCRL, but increased lymphatic pain risk among those with BCRL.
Conclusion
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.
{"title":"When Obesity Meets Lymphedema: Interaction Effects on Lymphatic Pain Among Chinese Breast Cancer Survivors","authors":"Aomei Shen , Yuhua Yang , Li Zhang , Nada Lukkahatai , Mei R. Fu , Shengwen Dong , Ying Wang , Hongmeng Zhao , Peipei Wu , Pan Yang , 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> < .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":"2025-12-18","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}
Pub 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":"2025-12-13","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}
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":"2025-12-10","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 : 2025-12-02DOI: 10.1016/j.clbc.2025.11.013
Xiaoqian Yu , Yijing Fan , Shufang Zhang , Lizhi Zhou , Jingxin Liu , Aiyun Du
Background
Chemotherapy-induced peripheral neuropathy (CIPN) is a common and debilitating side effect of taxane-based chemotherapy, significantly affecting patients’ quality of life. We investigated the effects of exercise combined with compression therapy on CIPN, 25-hydroxyvitamin D level, and body mass index in patients with breast cancer.
Methods
A total of 108 patients with peripheral neuropathy treated with albumin/paclitaxel (250 mg/m2) chemotherapy in the Breast Department of Tangshan People’s Hospital were selected and randomly divided into a general treatment group (Group G), compression therapy group (Group CG), and a combined exercise (EXCAP) and compression therapy group (Group ECG). The incidence of chemotherapy-induced peripheral neuropathy, 25-hydroxyvitamin D levels, and body mass index (BMI) were measured at baseline (preintervention) and after the 4-cycle intervention, and the differences between the 3 groups were compared.
Results
After intervention, Group ECG showed a 0.0% incidence of grade 2 CIPN versus 25.0% in CG and 50.0% in G (P < .001), with an absolute risk reduction of 50.0% (95% CI, 33.8% to 66.2%) compared to Group G, and a 100.0% incidence of grade 1 CIPN versus 75.0% in CG and 50.0% in G (P < .001). With a 19.99 ± 5.82 ng/mL in 25-hydroxyvitamin D (vs. 15.45 ± 4.58 in G, P < .001; mean difference: 4.54 ng/mL, 95% CI, 1.56-7.53) and BMI reduction to 23.10 ± 2.27 (vs. 26.96 ± 2.91 in G, P < .001, mean difference: −3.86 kg/m², 95% CI, −5.54 to −2.32).
Conclusion
Combined compression and exercise therapy can effectively reduce the incidence of chemotherapy-induced peripheral neuropathy, alleviate the decline in 25-hydroxyvitamin D levels, and control the body mass index in patients undergoing breast cancer chemotherapy. We recommend integrating compression therapy with EXCAP exercise into routine chemotherapy care to reduce CIPN incidence, manage BMI, and maintain vitamin D levels for better patient outcomes.
{"title":"Combined Compression and Exercise Therapy for Chemotherapy-Induced Peripheral Neuropathy in Breast Cancer: A Randomized Controlled Trial","authors":"Xiaoqian Yu , Yijing Fan , Shufang Zhang , Lizhi Zhou , Jingxin Liu , Aiyun Du","doi":"10.1016/j.clbc.2025.11.013","DOIUrl":"10.1016/j.clbc.2025.11.013","url":null,"abstract":"<div><h3>Background</h3><div>Chemotherapy-induced peripheral neuropathy (CIPN) is a common and debilitating side effect of taxane-based chemotherapy, significantly affecting patients’ quality of life. We investigated the effects of exercise combined with compression therapy on CIPN, 25-hydroxyvitamin D level, and body mass index in patients with breast cancer.</div></div><div><h3>Methods</h3><div>A total of 108 patients with peripheral neuropathy treated with albumin/paclitaxel (250 mg/m<sup>2</sup>) chemotherapy in the Breast Department of Tangshan People’s Hospital were selected and randomly divided into a general treatment group (Group G), compression therapy group (Group CG), and a combined exercise (EXCAP) and compression therapy group (Group ECG). The incidence of chemotherapy-induced peripheral neuropathy, 25-hydroxyvitamin D levels, and body mass index (BMI) were measured at baseline (preintervention) and after the 4-cycle intervention, and the differences between the 3 groups were compared.</div></div><div><h3>Results</h3><div>After intervention, Group ECG showed a 0.0% incidence of grade 2 CIPN versus 25.0% in CG and 50.0% in G (<em>P</em> < .001), with an absolute risk reduction of 50.0% (95% CI, 33.8% to 66.2%) compared to Group G, and a 100.0% incidence of grade 1 CIPN versus 75.0% in CG and 50.0% in G (<em>P</em> < .001). With a 19.99 ± 5.82 ng/mL in 25-hydroxyvitamin D (vs. 15.45 ± 4.58 in G, <em>P</em> < .001; mean difference: 4.54 ng/mL, 95% CI, 1.56-7.53) and BMI reduction to 23.10 ± 2.27 (vs. 26.96 ± 2.91 in G, <em>P</em> < .001, mean difference: −3.86 kg/m², 95% CI, −5.54 to −2.32).</div></div><div><h3>Conclusion</h3><div>Combined compression and exercise therapy can effectively reduce the incidence of chemotherapy-induced peripheral neuropathy, alleviate the decline in 25-hydroxyvitamin D levels, and control the body mass index in patients undergoing breast cancer chemotherapy. We recommend integrating compression therapy with EXCAP exercise into routine chemotherapy care to reduce CIPN incidence, manage BMI, and maintain vitamin D levels for better patient outcomes.</div></div>","PeriodicalId":10197,"journal":{"name":"Clinical breast cancer","volume":"26 1","pages":"Pages 105-113"},"PeriodicalIF":2.5,"publicationDate":"2025-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145827126","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-02DOI: 10.1016/j.clbc.2025.11.017
He Yijun, Lu Huixing, Wang Liping
Radiation therapy (RT) dynamically modulates the breast cancer immune microenvironment by inducing immunogenic cell death (ICD) and reshaping the tumor microenvironment. However, RT alone is often insufficient to achieve complete tumor eradication due to compensatory immunosuppressive mechanisms within the tumor microenvironment. The combination of RT with immune checkpoint inhibitors (ICIs) has thus emerged as a potent strategy to overcome these limitations, particularly in triple-negative breast cancer (TNBC).Preclinical studies confirm that radiotherapy fractionation regimens critically influence immune regulation: moderate hypo fractionated doses (eg, 8-12 Gy per fraction) optimally activate the cyclic GMP-AMP synthase-stimulator of interferon genes (cGAS-STING) pathway and promote CD8+T cell infiltration, whereas single ablative doses exceeding 15 Gy may attenuate immunogenicity by upregulating the DNA exonuclease Trex1. Clinical trials such as PEARL demonstrate that this combination regimen, Stereotactic body radiotherapy (SBRT) with ICIs and neoadjuvant chemotherapy) achieves a pathological complete response (pCR) rate of 59.2% in TNBC patients. Key challenges remain, including optimizing RT-ICI sequencing, managing overlapping toxicities (eg, pneumonitis), and validating predictive biomarkers such as tumor-infiltrating lymphocytes (TILs) and circulating tumor DNA (ctDNA). Future research will focus on integrating AI-driven radiotherapy with multi-omics to address tumor heterogeneity. Targeting immunosuppressive pathways like indoleamine 2,3-dioxygenase1 (IDO1) and histone deacetylase (HDAC) may enhance treatment efficacy. This review synthesizes mechanistic, clinical, and translational advances in radiotherapy-ICI combinations, providing a theoretical foundation and strategic outlook for optimizing precision breast cancer therapy.
{"title":"Research Progress of Radiotherapy Combined With Immunotherapy for Breast Cancer: Mechanism Exploration and Clinical Translation","authors":"He Yijun, Lu Huixing, Wang Liping","doi":"10.1016/j.clbc.2025.11.017","DOIUrl":"10.1016/j.clbc.2025.11.017","url":null,"abstract":"<div><div>Radiation therapy (RT) dynamically modulates the breast cancer immune microenvironment by inducing immunogenic cell death (ICD) and reshaping the tumor microenvironment. However, RT alone is often insufficient to achieve complete tumor eradication due to compensatory immunosuppressive mechanisms within the tumor microenvironment. The combination of RT with immune checkpoint inhibitors (ICIs) has thus emerged as a potent strategy to overcome these limitations, particularly in triple-negative breast cancer (TNBC).Preclinical studies confirm that radiotherapy fractionation regimens critically influence immune regulation: moderate hypo fractionated doses (eg, 8-12 Gy per fraction) optimally activate the cyclic GMP-AMP synthase-stimulator of interferon genes (cGAS-STING) pathway and promote CD8<sup>+</sup>T cell infiltration, whereas single ablative doses exceeding 15 Gy may attenuate immunogenicity by upregulating the DNA exonuclease Trex1. Clinical trials such as PEARL demonstrate that this combination regimen, Stereotactic body radiotherapy (SBRT) with ICIs and neoadjuvant chemotherapy) achieves a pathological complete response (pCR) rate of 59.2% in TNBC patients. Key challenges remain, including optimizing RT-ICI sequencing, managing overlapping toxicities (eg, pneumonitis), and validating predictive biomarkers such as tumor-infiltrating lymphocytes (TILs) and circulating tumor DNA (ctDNA). Future research will focus on integrating AI-driven radiotherapy with multi-omics to address tumor heterogeneity. Targeting immunosuppressive pathways like indoleamine 2,3-dioxygenase1 (IDO1) and histone deacetylase (HDAC) may enhance treatment efficacy. This review synthesizes mechanistic, clinical, and translational advances in radiotherapy-ICI combinations, providing a theoretical foundation and strategic outlook for optimizing precision breast cancer therapy.</div></div>","PeriodicalId":10197,"journal":{"name":"Clinical breast cancer","volume":"26 2","pages":"Pages 1-16"},"PeriodicalIF":2.5,"publicationDate":"2025-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145908800","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-01DOI: 10.1016/j.clbc.2025.11.015
Sabine Dieleman, Loes F S Kooreman, Michiel T H M Henkens, Axel Zur Hausen, Marjolein L Smidt, Heike I Grabsch
Background and aim: The sentinel lymph node (SLN) play a key role in the host antitumor immune response. Microarchitectural patterns in tumor-negative SLNs (SLNneg) may provide important clinical information about the host's antitumor immune response against breast cancer.
Methods: This retrospective cohort study included SLNneg from 339 breast cancer patients. SLNneg microarchitectural features (percentage (%) SLNneg area occupied by histiocytes, germinal centers, lymphocytes outside germinal centers, adipocytes, vessels or connective tissue) were quantified morphometrically. The relationship with 10-year disease-free survival (DFS) was investigated using Cox regression analyses. Variables showing a nonlinear relationship with survival, cubic spline analysis was used to identify distinct groups.
Results: SLNnegs were predominantly occupied by lymphocytes (median % SLNneg area: 60%) followed by histiocytes (14%), vessels (7%), connective tissue (5%), adipocytes (5%) and germinal centers (0.4%). Histiocyte quantity was related to survival in a nonlinear fashion with 9% and 21% as relevant cutoffs. Patients with < 9% or > 21% SLNneg area occupied by histiocytes had poorer survival compared to patients with 9% to 21% SLNneg area occupied by histiocytes (< 9% SLNneg area Hazard Ratio (HR) 2.5 (95% CI, 1.4-4.5), P = .001; > 21% SLNneg area HR 2.7 (1.5;4.7), P < .001; 9% to 21% SLNneg area = ref.), remaining significant in multivariable analysis. The other microarchitectural features were not related to survival.
Conclusion: This is the first study showing that quantity of histiocytes in SLNneg is associated with 10-year DFS in breast cancer in a nonlinear manner. This suggests that cell type specific morphological changes within the SLNneg reflect the host's antitumor immune response providing clinically relevant information in breast cancer patients.
{"title":"Histiocyte Quantity in Tumor-Negative Sentinel Lymph Nodes Predicts 10-Year Disease-Free Survival in Patients With Breast Cancer.","authors":"Sabine Dieleman, Loes F S Kooreman, Michiel T H M Henkens, Axel Zur Hausen, Marjolein L Smidt, Heike I Grabsch","doi":"10.1016/j.clbc.2025.11.015","DOIUrl":"https://doi.org/10.1016/j.clbc.2025.11.015","url":null,"abstract":"<p><strong>Background and aim: </strong>The sentinel lymph node (SLN) play a key role in the host antitumor immune response. Microarchitectural patterns in tumor-negative SLNs (SLNneg) may provide important clinical information about the host's antitumor immune response against breast cancer.</p><p><strong>Methods: </strong>This retrospective cohort study included SLNneg from 339 breast cancer patients. SLNneg microarchitectural features (percentage (%) SLNneg area occupied by histiocytes, germinal centers, lymphocytes outside germinal centers, adipocytes, vessels or connective tissue) were quantified morphometrically. The relationship with 10-year disease-free survival (DFS) was investigated using Cox regression analyses. Variables showing a nonlinear relationship with survival, cubic spline analysis was used to identify distinct groups.</p><p><strong>Results: </strong>SLNnegs were predominantly occupied by lymphocytes (median % SLNneg area: 60%) followed by histiocytes (14%), vessels (7%), connective tissue (5%), adipocytes (5%) and germinal centers (0.4%). Histiocyte quantity was related to survival in a nonlinear fashion with 9% and 21% as relevant cutoffs. Patients with < 9% or > 21% SLNneg area occupied by histiocytes had poorer survival compared to patients with 9% to 21% SLNneg area occupied by histiocytes (< 9% SLNneg area Hazard Ratio (HR) 2.5 (95% CI, 1.4-4.5), P = .001; > 21% SLNneg area HR 2.7 (1.5;4.7), P < .001; 9% to 21% SLNneg area = ref.), remaining significant in multivariable analysis. The other microarchitectural features were not related to survival.</p><p><strong>Conclusion: </strong>This is the first study showing that quantity of histiocytes in SLNneg is associated with 10-year DFS in breast cancer in a nonlinear manner. This suggests that cell type specific morphological changes within the SLNneg reflect the host's antitumor immune response providing clinically relevant information in breast cancer patients.</p>","PeriodicalId":10197,"journal":{"name":"Clinical breast cancer","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145833197","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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