Clinical breast cancer最新文献

{"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}

{"title":"CDK4/6 Inhibitors in HER2-positive Metastatic Breast Cancer","authors":"Hervé Bischoff,&nbsp;Thierry Petit","doi":"10.1016/j.clbc.2026.01.003","DOIUrl":"10.1016/j.clbc.2026.01.003","url":null,"abstract":"<div><div>HR +/HER2 + breast cancer (BC) represents a unique clinical entity distinct from HR−/HER2 + BC, with specific molecular characteristics and resistance mechanisms. The interaction between estrogen receptor (ER) and HER2 signaling pathways promotes tumor growth and therapeutic resistance, highlighting the need for tailored approaches. This review focuses on the clinical and molecular features of HR + /HER2 + metastatic BC, with an emphasis on recent data exploring the integration of CDK4/6 inhibitors (CDK4/6i) into anti-HER2 therapeutic strategies. Key findings from metastatic trials are summarized. HR + /HER2 + metastatic BC is characterized by a predominance of luminal molecular subtypes, associated with distinct patterns of metastatic spread and prolonged progression-free survival compared to nonluminal subtypes. Despite the efficacy of dual HER2 blockade, resistance remains a challenge, driven by crosstalk between ER and HER2 pathways. CDK4/6i disrupt the cell cycle at the G1/S checkpoint and have shown promise in overcoming resistance, inducing sustained senescence, and improving outcomes in luminal subtypes. Recent trials suggest that CDK4/6i may play a key role in maintenance therapy and chemotherapy-free regimens for selected patients with HR + /HER2 + metastatic BC. The integration of CDK4/6 inhibitors into anti-HER2 treatment strategies represents a promising approach to address the unique biology of HR + /HER2 + BC. Molecular profiling and personalized treatment strategies are essential to optimize patient outcomes and reduce unnecessary toxicity.</div></div>","PeriodicalId":10197,"journal":{"name":"Clinical breast cancer","volume":"26 2","pages":"Pages 93-104"},"PeriodicalIF":2.5,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146074578","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":"Effects of Different Glucose Concentrations and Hypoxia and its Impact on the Expression of Sox2 and CAIX in Breast Cancer: In Vitro And Silico Analysis","authors":"Niloufar Esmaeilizadeh MS.c ,&nbsp;Hadi Maleki-Kakelar PhD ,&nbsp;Rasoul Sharifi PhD ,&nbsp;Sevda Valilou MD ,&nbsp;Akbar Jalili MS.c ,&nbsp;Mohammad Reza Asgharzadeh PhD","doi":"10.1016/j.clbc.2025.08.023","DOIUrl":"10.1016/j.clbc.2025.08.023","url":null,"abstract":"<div><h3>Background</h3><div>Cancer is a an uncontrolled proliferation of transformed cells as a genetic variation in human diseases. In the present study, we investigated how different concentrations of glucose and hypoxia affect the expression of CAIX and Sox2 genes in breast cancer cell lines MCF-7 and MDA-MB-231.</div></div><div><h3>Methods</h3><div>MCF-7 and MDA-MB-231 cells were exposed to different concentrations of glucose (5.5, 11, and 25 mM), normoxia, and hypoxia. SNARF-AM labeling was used to quantify intracellular pH, which was then evaluated using flow cytometry. Finally, the expression levels of CAIX and Sox2 genes were examined using quantitative real-time PCR. In addition, the interaction of the ligand with carbonic anhydrase was analyzed using Chimera software, and the docking results were checked in the corresponding servers. The relationship between structural disorder and pH was investigated using DispHred.</div></div><div><h3>Results</h3><div>Metastasis and intracellular pH (pHi) are glucose-dependent in MCF-7 cells, but hypoxia-dependent in MDA-MB-231 cells. Our findings showed a significant increase in the expression of CAIX (<em>P</em> = .0032) and but Sox2 (<em>P</em> = .5309) also had an increase in expression, it was not significant in the MCF-7 cell line compared with control cells maintained in normal oxygen. In addition, the genes CAIX (<em>P</em> = .0712) and Sox2 (<em>P</em> = .0004) were up-regulated in MDA-MB-231 cells. The DispHred results showed that the total CAIX load changes somewhat with pH changes.</div></div><div><h3>Conclusions</h3><div>Increased or decreased glucose concentration and hypoxia lead to changes in the gene expression patterns of cancer cells. Consequently, the genes may be used as biomarkers to aid in the diagnosis and prognosis of breast cancer.</div></div>","PeriodicalId":10197,"journal":{"name":"Clinical breast cancer","volume":"26 2","pages":"Pages 228-237"},"PeriodicalIF":2.5,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145198623","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":"Knowledge, Awareness, Perceptions, and Attitudes Toward Breast Reconstruction Among Breast Cancer Women in Jordan: A Cross-Sectional Study","authors":"Saleh Abualhaj ,&nbsp;Lina Alshadfan ,&nbsp;Mosleh M. Abualhaj ,&nbsp;Yasmin Safi ,&nbsp;Mohammad Al-Share ,&nbsp;Huda Alzagatit ,&nbsp;Aseel Qandil ,&nbsp;Tamara Abdalkader ,&nbsp;Weam Sowan ,&nbsp;Younis Hizzani ,&nbsp;Zain aldeen Saleh ,&nbsp;Yousef Albustanji ,&nbsp;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> &lt; .001), those employed (<em>P</em> = .002), with higher education levels (<em>P</em> &lt; .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":"2026-02-01","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}

{"title":"Minutes that Matter? The Significance of Operative Time in Immediate Unilateral and Bilateral Free Flap Breast Reconstruction","authors":"Samuel Knoedler ,&nbsp;Thomas Schaschinger ,&nbsp;Felix J. Klimitz ,&nbsp;Fortunay Diatta ,&nbsp;Tobias Niederegger ,&nbsp;Leonard Knoedler ,&nbsp;Barbara Kern ,&nbsp;Henriette Grundig ,&nbsp;Julius M. Wirtz ,&nbsp;Doha Obed ,&nbsp;Mario Cherubino ,&nbsp;Raffi Gurunian ,&nbsp;Martin Kauke-Navarro ,&nbsp;Bohdan Pomahac","doi":"10.1016/j.clbc.2025.09.019","DOIUrl":"10.1016/j.clbc.2025.09.019","url":null,"abstract":"<div><h3>Background</h3><div>Free flap breast reconstruction (FFBR) offers substantial benefits after mastectomy. However, the impact of operative time on outcomes remains unclear.</div></div><div><h3>Patients and Methods</h3><div>In this retrospective cohort study, the American College of Surgeons National Surgical Quality Improvement Program database (2011-2022) was queried for patients undergoing immediate FFBR. Multivariate logistic regression assessed operative time as both a continuous and dichotomous variable. Thresholds for operative duration were determined using receiver operating characteristic (ROC) analysis and Youden's Index.</div></div><div><h3>Results</h3><div>Of 5826 patients, 61% underwent unilateral and 39% bilateral FFBR. Complications occurred in 27% of cases—25% in unilateral and 30% in bilateral procedures. In unilateral FFBR, prolonged operative time was significantly associated with increased risks of overall complications (OR 1.0020 per minute, <em>P</em> &lt; .001), surgical (OR 1.0023, <em>P &lt; .</em>001) and medical complications (OR 1.0019, <em>P = .</em>0011), reoperation (OR 1.0011, <em>P = .</em>013), and readmission (OR 1.0014, <em>P = .</em>0030). Each additional hour increased overall complication risk by 12%, with a 397-minute threshold identified (OR 1.8, <em>P &lt; .</em>001). For bilateral FFBR, longer operative time correlated with higher odds of overall complications (OR 1.0012 per minute, <em>P &lt; .</em>001), surgical complications (OR 1.0012, <em>P = .</em>0014), and reoperation (OR 1.0010, <em>P = .</em>026). A 7.2% increase in adverse event risk was noted per additional hour, with 536 minutes as a critical threshold (OR 1.6, <em>P &lt; .</em>001).</div></div><div><h3>Conclusion</h3><div>Prolonged operative time significantly increases complication risk in FFBR. Patients with procedures exceeding 397 and 536 minutes were 80% and 60% more likely to experience adverse events, respectively. These findings highlight the need to maximize surgical efficiency and minimize postoperative morbidity.</div></div>","PeriodicalId":10197,"journal":{"name":"Clinical breast cancer","volume":"26 2","pages":"Pages 304-312"},"PeriodicalIF":2.5,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145421390","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":"Digital Health Management via IKAP Theory Improves Upper Limb Function and Psychological Adaptation in Postmastectomy Patients: A Randomized Controlled Trial","authors":"Panpan Xu ,&nbsp;Xiaomei Zhang ,&nbsp;Lihua Lu ,&nbsp;Xiaofeng Chen ,&nbsp;Yunxia Chen ,&nbsp;Jia Chen ,&nbsp;Xiaoling Yan ,&nbsp;Xiaohong Jin ,&nbsp;Yiju Li","doi":"10.1016/j.clbc.2025.08.017","DOIUrl":"10.1016/j.clbc.2025.08.017","url":null,"abstract":"<div><h3>Objective</h3><div>This study aimed to evaluate IKAP theory-based digital health management in improving upper limb function and psychological adaptation in postmastectomy breast cancer survivors.</div></div><div><h3>Methods</h3><div>We conducted a two-arm, parallel-group RCT with 200 postmastectomy patients at Nantong University Affiliated Hospital from July to December 2024. All patients were divided into two categories: 100 patients each in the experimental and control groups. The experimental group underwent a 12-week digital health management using IKAP theory, and the control group received routine care. We assessed all primary outcome measures, including the Information Needs Questionnaire (INQ), the Disabilities of the Arm, Shoulder and Hand (DASH) scale, the Cancer Post-Traumatic Growth Inventory (C-PTGI), the Breast Cancer Postoperative Functional Exercise Adherence Scale, and the Functional Assessment of Cancer Therapy—Breast (FACT-B) Questionnaire, at two distinct time points: before and after the intervention.</div></div><div><h3>Results</h3><div>After 12 weeks of IKAP theory-based digital health management, breast cancer patients exhibited reduced information needs compared with the control group. Furthermore, this cohort exhibited marked improvement in upper extremity dysfunction when compared with the control cohort. The experimental group’s post-traumatic growth levels, compliance with postoperative functional exercises, and quality of life were higher than the control group, respectively. The inter-group differences in all these indicators were statistically significant (<em>P</em> &lt; .01).</div></div><div><h3>Conclusion</h3><div>IKAP theory-based digital health management significantly enhanced breast cancer survivors’ functional recovery and psychological adaptation.</div></div>","PeriodicalId":10197,"journal":{"name":"Clinical breast cancer","volume":"26 2","pages":"Pages 161-169"},"PeriodicalIF":2.5,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145205778","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":"CanAssist Breast Provides Additional Insightful Prognostic Information in Retrospective, Pooled Secondary Analysis in Clinically Low/ High-Risk Patients With HR+/HER2- EBC","authors":"Tejal Deepak Durgekar ,&nbsp;Susmita Ghosh ,&nbsp;Badada Ananthamurthy Savitha,&nbsp;Payal Shrivastava,&nbsp;Naveen Krishnamoorthy,&nbsp;Manvi Sunder,&nbsp;Deepti KS,&nbsp;Manjiri Bakre","doi":"10.1016/j.clbc.2025.08.022","DOIUrl":"10.1016/j.clbc.2025.08.022","url":null,"abstract":"<div><h3>Background</h3><div>In patients with early-stage HR+/ HER2- breast cancer, younger age, node positivity (N+), and higher Ki67 index are considered ``clinically high-risk'' and are treated with chemotherapy, although some can do well without it. Chemotherapy is often avoided in ``clinically low-risk'' patients with older age, small (T1-T2) or node-negative (N0) or lower Ki67 tumors; however, some of these patients do recur. Unlike earlier studies, this study aimed to explore the potential of CanAssist Breast (CAB), a prognostic test in providing ``additional'' information beyond ``clinicopathological parameters'' in ``clinically'' low-risk/ high-risk patients for effective treatment management.</div></div><div><h3>Methods</h3><div>This is a secondary pooled data analysis of previously published retrospective studies wherein CAB risk stratification data of 3045 patients were used to assess the risk of recurrence at five years from diagnosis. Distant recurrence-free interval (DRFI) was evaluated from Kaplan–Meier curves.</div></div><div><h3>Results</h3><div>In patients having N0 disease, CAB identified 13% and 8% high-risk patients with small tumors and small tumors with low Ki67 levels, respectively. In patients with N+ disease, CAB identified 44% of patients with higher Ki67 (≥20%) as low-risk. In younger patients, CAB identified &gt;46% of patients as low-risk. In low ER-expressing patients, CAB identified 67% of patients as low-risk. All CAB low-risk patients have an acceptable DRFI of ≥ 89% at five years from diagnosis.</div></div><div><h3>Conclusions</h3><div>CAB provides additional prognostic information by identifying ``low-risk'' and ``high-risk'' patients from the ``clinically'' high-risk and low-risk groups, thereby guiding oncologists to either avoid aggressive therapies or govern significant treatment decisions on additional therapies.</div></div>","PeriodicalId":10197,"journal":{"name":"Clinical breast cancer","volume":"26 2","pages":"Pages 216-227.e1"},"PeriodicalIF":2.5,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145174027","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":"Research Progress of Radiotherapy Combined With Immunotherapy for Breast Cancer: Mechanism Exploration and Clinical Translation","authors":"He Yijun,&nbsp;Lu Huixing,&nbsp;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⁺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":"2026-02-01","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}

{"title":"Positive Immunoreactivities of TM9SF1 and EBAG9 are Associated With Poor Prognosis in Patients With Triple-Negative Breast Cancer","authors":"Keiichi Kinowaki ,&nbsp;Toshihiko Takeiwa ,&nbsp;Kazuhiro Ikeda ,&nbsp;Akihiro Fujimoto ,&nbsp;Kotaro Azuma ,&nbsp;Kuniko Horie ,&nbsp;Hidetaka Kawabata ,&nbsp;Satoshi Inoue","doi":"10.1016/j.clbc.2025.09.007","DOIUrl":"10.1016/j.clbc.2025.09.007","url":null,"abstract":"<div><h3>Introduction</h3><div>TNBC demonstrates poor prognosis compared to other breast cancer types due to the lack of targetable molecular markers. Protein expression of EBAG9 has been associated with unfavorable prognosis in patients with various malignancies. Recently, we identified TM9SF1 protein as a binding partner for EBAG9 protein. However, the clinical relevance of TM9SF1 and EBAG9 in TNBC remains unclear.</div></div><div><h3>Patients and Methods</h3><div>We investigated the clinicopathological significance of TM9SF1 and EBAG9 in 116 Japanese female TNBC patients using immunohistochemical analysis.</div></div><div><h3>Results</h3><div>Immunohistochemical analysis demonstrated that IRs of both TM9SF1 and EBAG9 were significantly associated with decreased distant disease-free survival and overall survival. TM9SF1 IR was positively correlated with EBAG9 IR. These findings suggest that both TM9SF1 and EBAG9 IRs represent promising prognostic markers in TNBC.</div></div>","PeriodicalId":10197,"journal":{"name":"Clinical breast cancer","volume":"26 2","pages":"Pages 259-267.e6"},"PeriodicalIF":2.5,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145279075","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}