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A novel formula to improve the accuracy and prognostic ability of determining the survival time after recurrent breast cancer.
IF 4 3区 医学 Q1 OBSTETRICS & GYNECOLOGY Pub Date : 2025-02-18 DOI: 10.1007/s12282-025-01677-8
Reiki Nishimura, Yasuaki Sagara, Reiko Mitsueda, Tetsuhiko Taira, Toshiko Miyaki, Shuichi Kanemitsu, Megumi Teraoka, Junko Kawano, Naomi Gondo, Yoshitaka Fujiki, Ryutaro Higashi, Akiko Semba, Yasuyo Ohi, Yoshiaki Rai, Yoshiaki Sagara, Shinji Ohno

Background: Recurrent breast cancer (BC) has poor prognosis. To ascertain the survival time after recurrence (STR) is necessary for improving QOL and for selecting appropriate treatment. An investigation was conducted to determine whether certain biomarkers would improve prognosis and whether the disease-free interval (DFI) and biomarkers can predict STR.

Methods: Cases (n = 1,254) with recurrent BC from January 2000 to December 2023 were enrolled in this study. The cases were divided into the 2000-2005 group (n = 182), 2006-2011 group (n = 331), 2012-2017 group (n = 369), and 2018-2023 group (n = 366). A simple linear regression model was used to identify the relationship between STR and DFI.

Results: Survival rates after recurrence significantly increased in cases after 2012. No improvement was observed in cases with a HER2-0 status and a Ki-67 index value < 15%. A multivariate analysis revealed that the Ki-67 index value was a significant factor in the 2000-2005 group. The ER and HER2 status were significant after 2012. The most significant correlation was found between DFI and STR in deceased patients with a Ki-67 index value > 30%, followed by HER2-low, tumor size ≤ 2 cm and ER < 1%. The following formula was developed to predict STR; STR (mons) = α 0 + β 0 DFI + i = 1 5 F i α i + β i DFI CONCLUSION: Prognosis after recurrence clearly improved from 2012. In recurrent deceased patients, there was a strong correlation between DFI and STR in cases with a Ki-67 index value > 30% and a HER2-low status. Further studies need to be conducted in clinical settings to verify the accuracy of the predictive formula developed for STR.

{"title":"A novel formula to improve the accuracy and prognostic ability of determining the survival time after recurrent breast cancer.","authors":"Reiki Nishimura, Yasuaki Sagara, Reiko Mitsueda, Tetsuhiko Taira, Toshiko Miyaki, Shuichi Kanemitsu, Megumi Teraoka, Junko Kawano, Naomi Gondo, Yoshitaka Fujiki, Ryutaro Higashi, Akiko Semba, Yasuyo Ohi, Yoshiaki Rai, Yoshiaki Sagara, Shinji Ohno","doi":"10.1007/s12282-025-01677-8","DOIUrl":"https://doi.org/10.1007/s12282-025-01677-8","url":null,"abstract":"<p><strong>Background: </strong>Recurrent breast cancer (BC) has poor prognosis. To ascertain the survival time after recurrence (STR) is necessary for improving QOL and for selecting appropriate treatment. An investigation was conducted to determine whether certain biomarkers would improve prognosis and whether the disease-free interval (DFI) and biomarkers can predict STR.</p><p><strong>Methods: </strong>Cases (n = 1,254) with recurrent BC from January 2000 to December 2023 were enrolled in this study. The cases were divided into the 2000-2005 group (n = 182), 2006-2011 group (n = 331), 2012-2017 group (n = 369), and 2018-2023 group (n = 366). A simple linear regression model was used to identify the relationship between STR and DFI.</p><p><strong>Results: </strong>Survival rates after recurrence significantly increased in cases after 2012. No improvement was observed in cases with a HER2-0 status and a Ki-67 index value < 15%. A multivariate analysis revealed that the Ki-67 index value was a significant factor in the 2000-2005 group. The ER and HER2 status were significant after 2012. The most significant correlation was found between DFI and STR in deceased patients with a Ki-67 index value > 30%, followed by HER2-low, tumor size ≤ 2 cm and ER < 1%. The following formula was developed to predict STR; <math><mrow><mtext>STR (mons)</mtext> <mo>=</mo> <msub><mi>α</mi> <mn>0</mn></msub> <mo>+</mo> <msub><mi>β</mi> <mn>0</mn></msub> <mo>∙</mo> <mtext>DFI</mtext> <mo>+</mo> <msubsup><mo>∑</mo> <mrow><mi>i</mi> <mo>=</mo> <mn>1</mn></mrow> <mn>5</mn></msubsup> <msub><mi>F</mi> <mi>i</mi></msub> <mfenced><msub><mi>α</mi> <mi>i</mi></msub> <mo>+</mo> <msub><mi>β</mi> <mi>i</mi></msub> <mo>∙</mo> <mtext>DFI</mtext></mfenced> </mrow> </math> CONCLUSION: Prognosis after recurrence clearly improved from 2012. In recurrent deceased patients, there was a strong correlation between DFI and STR in cases with a Ki-67 index value > 30% and a HER2-low status. Further studies need to be conducted in clinical settings to verify the accuracy of the predictive formula developed for STR.</p>","PeriodicalId":56083,"journal":{"name":"Breast Cancer","volume":" ","pages":""},"PeriodicalIF":4.0,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143442886","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}
引用次数: 0
Refining the role of surgery in de novo stage IV breast cancer: the need for biomarkers and mechanistic insights.
IF 4 3区 医学 Q1 OBSTETRICS & GYNECOLOGY Pub Date : 2025-02-17 DOI: 10.1007/s12282-025-01681-y
Mariam Rizk, Kefah Mokbel
{"title":"Refining the role of surgery in de novo stage IV breast cancer: the need for biomarkers and mechanistic insights.","authors":"Mariam Rizk, Kefah Mokbel","doi":"10.1007/s12282-025-01681-y","DOIUrl":"10.1007/s12282-025-01681-y","url":null,"abstract":"","PeriodicalId":56083,"journal":{"name":"Breast Cancer","volume":" ","pages":""},"PeriodicalIF":4.0,"publicationDate":"2025-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143442917","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}
引用次数: 0
Repeated sentinel lymph node biopsy for local recurrence after breast-conserving surgery.
IF 4 3区 医学 Q1 OBSTETRICS & GYNECOLOGY Pub Date : 2025-02-13 DOI: 10.1007/s12282-025-01679-6
Yuka Matsubara, Nobuyasu Suganuma, Shogo Nakamoto, Yuichiro Kikawa, Takayuki Iwamoto, Takashi Yamanaka, Tatsuya Yoshida, Toshinari Yamashita, Aya Saitou

Background: In the realm of surgical therapy for cN0 early breast cancer, sentinel lymph node biopsy (SNB) has been established as a technique that allows the omission of axillary lymph node dissection (Ax) while maintaining local control in the axillary region.

Methods: This retrospective study analyzed data from 52 patients who underwent reSNB for IBTR after initial breast-conserving surgery at Kanagawa Cancer Center between June 2012 and March 2019. reSNB was conducted using both the dye and radioactive isotope methods. The identification rate was defined as the number of cases in which sentinel lymph nodes were visualized on lymphoscintigraphy images divided by the total number of cases. The identification rate was compared according to the initial surgical procedure.

Results: Overall, the identification rate for reSNB was 94.2%. The identification rate for reSNB in the axilla was higher in patients who initially underwent SNB than in those who initially underwent axillary lymph node dissection (83.3% vs. 42.9%). ReSNB positivity was observed in three patients (6.7%) in the ipsilateral axilla, whereas no metastasis was detected in the contralateral axilla or internal mammary region. Although four cases of recurrence were observed after reoperation, there was no local recurrence in the ipsilateral axillary region.

Conclusions: reSNB demonstrated high identification rates, comparable to those of initial SNB, with a low rate of positive metastasis and no local recurrence in the ipsilateral axillary region. Despite the limited number of cases, these findings suggest the clinical significance of reSNB in IBTR cases.

{"title":"Repeated sentinel lymph node biopsy for local recurrence after breast-conserving surgery.","authors":"Yuka Matsubara, Nobuyasu Suganuma, Shogo Nakamoto, Yuichiro Kikawa, Takayuki Iwamoto, Takashi Yamanaka, Tatsuya Yoshida, Toshinari Yamashita, Aya Saitou","doi":"10.1007/s12282-025-01679-6","DOIUrl":"https://doi.org/10.1007/s12282-025-01679-6","url":null,"abstract":"<p><strong>Background: </strong>In the realm of surgical therapy for cN0 early breast cancer, sentinel lymph node biopsy (SNB) has been established as a technique that allows the omission of axillary lymph node dissection (Ax) while maintaining local control in the axillary region.</p><p><strong>Methods: </strong>This retrospective study analyzed data from 52 patients who underwent reSNB for IBTR after initial breast-conserving surgery at Kanagawa Cancer Center between June 2012 and March 2019. reSNB was conducted using both the dye and radioactive isotope methods. The identification rate was defined as the number of cases in which sentinel lymph nodes were visualized on lymphoscintigraphy images divided by the total number of cases. The identification rate was compared according to the initial surgical procedure.</p><p><strong>Results: </strong>Overall, the identification rate for reSNB was 94.2%. The identification rate for reSNB in the axilla was higher in patients who initially underwent SNB than in those who initially underwent axillary lymph node dissection (83.3% vs. 42.9%). ReSNB positivity was observed in three patients (6.7%) in the ipsilateral axilla, whereas no metastasis was detected in the contralateral axilla or internal mammary region. Although four cases of recurrence were observed after reoperation, there was no local recurrence in the ipsilateral axillary region.</p><p><strong>Conclusions: </strong>reSNB demonstrated high identification rates, comparable to those of initial SNB, with a low rate of positive metastasis and no local recurrence in the ipsilateral axillary region. Despite the limited number of cases, these findings suggest the clinical significance of reSNB in IBTR cases.</p>","PeriodicalId":56083,"journal":{"name":"Breast Cancer","volume":" ","pages":""},"PeriodicalIF":4.0,"publicationDate":"2025-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143411717","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}
引用次数: 0
A prospective cohort study of abemaciclib-induced interstitial lung disease in metastatic breast cancer after chemotherapy.
IF 4 3区 医学 Q1 OBSTETRICS & GYNECOLOGY Pub Date : 2025-02-10 DOI: 10.1007/s12282-025-01680-z
Sayuka Nakayama, Takayuki Iwamoto, Kazuhiro Araki, Kazutaka Narui, Takahiro Nakayama, Hiroyuki Nagase, Naoya Sugimoto, Naruto Taira, Tomohiko Aihara, Yuichiro Kikawa, Hirofumi Mukai

Background: The safety of combination therapy with abemaciclib and hormone therapy in patients with hormone receptor-positive (HR +), human epidermal growth factor receptor 2-negative (HER2-) metastatic breast cancer (MBC) who were previously treated with chemotherapy for MBC remains unclear. Caution is required as the Pharmaceuticals and Medical Devices Agency (PMDA) and the U.S. Food and Drug Administration (FDA) have issued warnings about abemaciclib-induced interstitial lung disease (ILD).

Methods: This study was a secondary analysis of a prospective observational study involving patients who had previously undergone chemotherapy for HR + MBC. A certificated respiratory specialist reviewed the clinical information of patients who were suspected of having ILD to adjudicate abemaciclib-induced ILD and definitively diagnosed abemaciclib-induced ILD. In this study, the incidence, risk factors, and clinical course of interstitial lung disease (ILD) are reported.

Results: All cases of patients who received abemaciclib had no radiological evidence of ILD prior to abemaciclib treatment. The incidence of abemaciclib-induced ILD was 7.4% (n = 9/122). CTCAE grade 1/2 occurred in 77.8% (n = 7), with no grade 4/5 cases. The timing of ILD onset varied and our study did not identify any significant risk factors for abemaciclib-induced ILD. All cases of ILD ultimately were confirmed to be in remission or cured.

Conclusion: In this multicenter prospective cohort study with a follow-up period of 3.3 years and a definition of ILD by a certified pulmonologist, we accurately evaluated abemaciclib-associated ILD after chemotherapy. The favorable clinical course of ILD indicate that abemaciclib treatment is an acceptable option for these MBC patients. However, because abemaciclib-induced ILD is difficult to predict, careful monitoring is required during abemaciclib treatment.

{"title":"A prospective cohort study of abemaciclib-induced interstitial lung disease in metastatic breast cancer after chemotherapy.","authors":"Sayuka Nakayama, Takayuki Iwamoto, Kazuhiro Araki, Kazutaka Narui, Takahiro Nakayama, Hiroyuki Nagase, Naoya Sugimoto, Naruto Taira, Tomohiko Aihara, Yuichiro Kikawa, Hirofumi Mukai","doi":"10.1007/s12282-025-01680-z","DOIUrl":"https://doi.org/10.1007/s12282-025-01680-z","url":null,"abstract":"<p><strong>Background: </strong>The safety of combination therapy with abemaciclib and hormone therapy in patients with hormone receptor-positive (HR +), human epidermal growth factor receptor 2-negative (HER2-) metastatic breast cancer (MBC) who were previously treated with chemotherapy for MBC remains unclear. Caution is required as the Pharmaceuticals and Medical Devices Agency (PMDA) and the U.S. Food and Drug Administration (FDA) have issued warnings about abemaciclib-induced interstitial lung disease (ILD).</p><p><strong>Methods: </strong>This study was a secondary analysis of a prospective observational study involving patients who had previously undergone chemotherapy for HR + MBC. A certificated respiratory specialist reviewed the clinical information of patients who were suspected of having ILD to adjudicate abemaciclib-induced ILD and definitively diagnosed abemaciclib-induced ILD. In this study, the incidence, risk factors, and clinical course of interstitial lung disease (ILD) are reported.</p><p><strong>Results: </strong>All cases of patients who received abemaciclib had no radiological evidence of ILD prior to abemaciclib treatment. The incidence of abemaciclib-induced ILD was 7.4% (n = 9/122). CTCAE grade 1/2 occurred in 77.8% (n = 7), with no grade 4/5 cases. The timing of ILD onset varied and our study did not identify any significant risk factors for abemaciclib-induced ILD. All cases of ILD ultimately were confirmed to be in remission or cured.</p><p><strong>Conclusion: </strong>In this multicenter prospective cohort study with a follow-up period of 3.3 years and a definition of ILD by a certified pulmonologist, we accurately evaluated abemaciclib-associated ILD after chemotherapy. The favorable clinical course of ILD indicate that abemaciclib treatment is an acceptable option for these MBC patients. However, because abemaciclib-induced ILD is difficult to predict, careful monitoring is required during abemaciclib treatment.</p>","PeriodicalId":56083,"journal":{"name":"Breast Cancer","volume":" ","pages":""},"PeriodicalIF":4.0,"publicationDate":"2025-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143384174","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}
引用次数: 0
Breast cancer screening rates and influencing factors among LGBTQ groups in Japan.
IF 4 3区 医学 Q1 OBSTETRICS & GYNECOLOGY Pub Date : 2025-02-08 DOI: 10.1007/s12282-025-01669-8
Akemi Hara, Akihiko Ozaki, Michio Murakami, Hiroaki Saito, Mika Nashimoto, Daisuke Hori, Masaharu Tsubokura, Kenji Gonda, Masahiro Wada, Kazunoshin Tachibana, Tohru Ohtake, Takahiro Tabuchi

Background: Lesbian, gay, bisexual, transgender, and queer (LGBTQ) individuals face significant health disparities worldwide, particularly in preventive medicine. In Japan, where breast cancer has the highest incidence rate among women, understanding screening behaviors among LGBTQ individuals is crucial for improving public health outcomes.

Objective: This study aimed to elucidate the relationship between LGBTQ status and breast cancer screening behaviors in Japan, identifying factors influencing screening uptake and highlighting challenges in health management for the LGBTQ community.

Methods: Using data from the Japan COVID-19 and Society Internet Survey (JACSIS), we analyzed breast cancer screening status among 11,056 biological females. Multinomial logistic regression and stratified regression analyzes were employed to examine factors associated with screening behavior, comparing LGBTQ and non-LGBTQ groups.

Results: LGBTQ individuals demonstrated significantly lower odds of undergoing breast cancer screening (OR 0.82, 95% CI 0.73-0.91, p < 0.001) compared to non-LGBTQ individuals. Key factors influencing lower screening rates among individuals in the survey were primarily linked to LGBTQ identity, followed by higher rates of being uninsured, unmarried status, lower income levels, alcohol consumption. Stratified analysis revealed that uninsured LGBTQ individuals had significantly lower odds of screening (OR 0.23, 95% CI 0.08-0.70, p = 0.01) compared to those with national health insurance.

Conclusion: This study identifies noteworthy differences in breast cancer screening behaviors between LGBTQ and non-LGBTQ individuals in Japan, as indicated by lower odds of screening participation among LGBTQ individuals, even after adjusting for socioeconomic factors. Findings underscore the need for targeted interventions, including improved healthcare access, LGBTQ-friendly medical environments, and awareness campaigns to address these disparities and promote health equity within the LGBTQ community.

{"title":"Breast cancer screening rates and influencing factors among LGBTQ groups in Japan.","authors":"Akemi Hara, Akihiko Ozaki, Michio Murakami, Hiroaki Saito, Mika Nashimoto, Daisuke Hori, Masaharu Tsubokura, Kenji Gonda, Masahiro Wada, Kazunoshin Tachibana, Tohru Ohtake, Takahiro Tabuchi","doi":"10.1007/s12282-025-01669-8","DOIUrl":"https://doi.org/10.1007/s12282-025-01669-8","url":null,"abstract":"<p><strong>Background: </strong>Lesbian, gay, bisexual, transgender, and queer (LGBTQ) individuals face significant health disparities worldwide, particularly in preventive medicine. In Japan, where breast cancer has the highest incidence rate among women, understanding screening behaviors among LGBTQ individuals is crucial for improving public health outcomes.</p><p><strong>Objective: </strong>This study aimed to elucidate the relationship between LGBTQ status and breast cancer screening behaviors in Japan, identifying factors influencing screening uptake and highlighting challenges in health management for the LGBTQ community.</p><p><strong>Methods: </strong>Using data from the Japan COVID-19 and Society Internet Survey (JACSIS), we analyzed breast cancer screening status among 11,056 biological females. Multinomial logistic regression and stratified regression analyzes were employed to examine factors associated with screening behavior, comparing LGBTQ and non-LGBTQ groups.</p><p><strong>Results: </strong>LGBTQ individuals demonstrated significantly lower odds of undergoing breast cancer screening (OR 0.82, 95% CI 0.73-0.91, p < 0.001) compared to non-LGBTQ individuals. Key factors influencing lower screening rates among individuals in the survey were primarily linked to LGBTQ identity, followed by higher rates of being uninsured, unmarried status, lower income levels, alcohol consumption. Stratified analysis revealed that uninsured LGBTQ individuals had significantly lower odds of screening (OR 0.23, 95% CI 0.08-0.70, p = 0.01) compared to those with national health insurance.</p><p><strong>Conclusion: </strong>This study identifies noteworthy differences in breast cancer screening behaviors between LGBTQ and non-LGBTQ individuals in Japan, as indicated by lower odds of screening participation among LGBTQ individuals, even after adjusting for socioeconomic factors. Findings underscore the need for targeted interventions, including improved healthcare access, LGBTQ-friendly medical environments, and awareness campaigns to address these disparities and promote health equity within the LGBTQ community.</p>","PeriodicalId":56083,"journal":{"name":"Breast Cancer","volume":" ","pages":""},"PeriodicalIF":4.0,"publicationDate":"2025-02-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143375048","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}
引用次数: 0
Economic impact of screening on postdiagnosis work productivity in Japanese women with breast cancer: a life-table modeling approach. 日本女性乳腺癌患者筛查对诊断后工作生产率的经济影响:生命表建模方法。
IF 4 3区 医学 Q1 OBSTETRICS & GYNECOLOGY Pub Date : 2025-01-01 Epub Date: 2024-10-04 DOI: 10.1007/s12282-024-01637-8
Yoshie Takatori-Shirakami, Mitsue Saito, Kazuhito Yokoyama

Background: In Japan, biennial mammography screening has been recommended for the early detection of breast cancer (BC) in women aged 40 years or above since 2004 by the Ministry of Health, Labor and Welfare. The purpose of this study is to estimate the economic impact of BC screening on work productivity, using a new measure called the productivity-adjusted life-year (PALY).

Methods: We used a dynamic life table modeling approach to estimate the work productivity of female patients aged 40-64 years diagnosed with BC in 2019 over the year of diagnosis and the subsequent 5 years. Changes in life-years, PALYs, and gross domestic product (GDP) were assessed by changing the screening detection rate from the current (34.2%) to an ideal (100%) percentage. Each input for modeling was obtained from the most recent public database available.

Results: BC patients were estimated to lose 1903 in life-years, 3596 in PALYs, and US$281 million in GDP at the current screening detection rate compared with the ideal detection rate. On the other hand, the following gains are expected when the current screening detection rate was increased to 40-80%; life-years gain; 168-1325, PALYs gain; 317-2503, GDP gain: US$25-196 million.

Conclusion: This study has used modeling to show that detecting BC without screening is associated with a lower work productivity and an economic and life-years loss. Encouraging BC screening may be beneficial to maintaining work productivity after diagnosis.

背景:自 2004 年起,日本厚生劳动省建议 40 岁及以上女性每两年进行一次乳房 X 线照相筛查,以早期发现乳腺癌(BC)。本研究的目的是采用一种名为 "生产率调整生命年"(PALY)的新方法,估算乳腺癌筛查对工作生产率的经济影响:我们采用动态生命表建模方法估算了 2019 年确诊 BC 的 40-64 岁女性患者在确诊当年及其后 5 年的工作生产率。通过将筛查检出率从目前的 34.2% 改为理想的 100% 来评估生命年、PALYs 和国内生产总值 (GDP) 的变化。建模的各项输入数据均来自现有的最新公共数据库:与理想的筛查率相比,在目前的筛查率下,估计 BC 患者将损失 1903 个生命年、3596 个 PALYs 和 2.81 亿美元的 GDP。另一方面,当目前的筛查检出率提高到 40%-80% 时,预计会有以下收益:生命年收益;168-1325 年,PALYs 收益;317-2503 年,GDP 收益:结论:本研究通过建模表明,不进行筛查而检测出 BC 会降低工作效率,造成经济和生命年损失。鼓励进行乳腺癌筛查可能有利于在确诊后保持工作效率。
{"title":"Economic impact of screening on postdiagnosis work productivity in Japanese women with breast cancer: a life-table modeling approach.","authors":"Yoshie Takatori-Shirakami, Mitsue Saito, Kazuhito Yokoyama","doi":"10.1007/s12282-024-01637-8","DOIUrl":"10.1007/s12282-024-01637-8","url":null,"abstract":"<p><strong>Background: </strong>In Japan, biennial mammography screening has been recommended for the early detection of breast cancer (BC) in women aged 40 years or above since 2004 by the Ministry of Health, Labor and Welfare. The purpose of this study is to estimate the economic impact of BC screening on work productivity, using a new measure called the productivity-adjusted life-year (PALY).</p><p><strong>Methods: </strong>We used a dynamic life table modeling approach to estimate the work productivity of female patients aged 40-64 years diagnosed with BC in 2019 over the year of diagnosis and the subsequent 5 years. Changes in life-years, PALYs, and gross domestic product (GDP) were assessed by changing the screening detection rate from the current (34.2%) to an ideal (100%) percentage. Each input for modeling was obtained from the most recent public database available.</p><p><strong>Results: </strong>BC patients were estimated to lose 1903 in life-years, 3596 in PALYs, and US$281 million in GDP at the current screening detection rate compared with the ideal detection rate. On the other hand, the following gains are expected when the current screening detection rate was increased to 40-80%; life-years gain; 168-1325, PALYs gain; 317-2503, GDP gain: US$25-196 million.</p><p><strong>Conclusion: </strong>This study has used modeling to show that detecting BC without screening is associated with a lower work productivity and an economic and life-years loss. Encouraging BC screening may be beneficial to maintaining work productivity after diagnosis.</p>","PeriodicalId":56083,"journal":{"name":"Breast Cancer","volume":" ","pages":"101-108"},"PeriodicalIF":4.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142373631","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}
引用次数: 0
Clinicopathogenomic analysis of PI3K/AKT/PTEN-altered luminal metastatic breast cancer in Japan. 日本PI3K/AKT/PTEN改变的管腔转移性乳腺癌的临床病原学分析。
IF 4 3区 医学 Q1 OBSTETRICS & GYNECOLOGY Pub Date : 2025-01-01 Epub Date: 2024-10-28 DOI: 10.1007/s12282-024-01639-6
Hiroshi Tada, Minoru Miyashita, Narumi Harada-Shoji, Akiko Ebata, Miku Sato, Tokiwa Motonari, Mika Yanagaki, Tomomi Kon, Aru Sakamoto, Takanori Ishida

This rapid communication highlights the correlation between protein kinase B alpha (AKT1)-phosphatidylinositol-4,5-bisphosphate 3-kinase catalytic subunit alpha (PIK3CA)- phosphatase and tensin homolog (PTEN) alterations and clinicopathological factors in Japanese patients with metastatic recurrent breast cancer (mBC). This study analyzed 1967 patients with luminal-type breast cancer who underwent cancer gene panel testing. The results demonstrated that AKT pathway alterations, including PI3K/AKT/PTEN, occurred in 1038 (52.8%) cases. Patients with AKT pathway mutations were older (p = 0.002) and had a higher rate of invasive lobular carcinoma (ILC) histology (p = 0.001), progesterone receptor (PgR) positivity (p = 0.006), and bone metastases (p = 0.001), and a lower rate of germline BRCA2 (p < 0.001). Comprehensive genomic profile results demonstrated a higher tumor mutational burden (TMB) (< 0.001) and lower tumor BRCA1/2 expression (< 0.001) in patients with mutations in the AKT pathway. These results are crucial for characterizing candidates for AKT pathway-targeted molecular therapies and conceptualizing optimal treatment strategies. Clinical trial registration: This study is an observational study and is therefore not registered with the clinical trials registration.

这篇快速通讯强调了日本转移性复发性乳腺癌(mBC)患者中蛋白激酶Bα(AKT1)-磷脂酰肌醇-4,5-二磷酸3-激酶催化亚基α(PIK3CA)-磷酸酶和天丝同源物(PTEN)改变与临床病理因素之间的相关性。这项研究分析了 1967 名接受癌症基因面板检测的腔镜型乳腺癌患者。结果显示,1038 例(52.8%)患者发生了 AKT 通路改变,包括 PI3K/AKT/PTEN。AKT通路突变的患者年龄较大(p = 0.002),浸润性小叶癌(ILC)组织学(p = 0.001)、孕酮受体(PgR)阳性(p = 0.006)和骨转移(p = 0.001)率较高,生殖系BRCA2(p = 0.001)率较低。
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引用次数: 0
Mirror therapy for patients with breast cancer: A systematic review and meta-analysis. 乳腺癌患者的镜像疗法:系统回顾和荟萃分析。
IF 4 3区 医学 Q1 OBSTETRICS & GYNECOLOGY Pub Date : 2025-01-01 Epub Date: 2024-10-05 DOI: 10.1007/s12282-024-01642-x
Jie Hao, Andréas Remis, Dongqi Zhu, Yao Yao, Yupi Pu, Yanfei Li, Biying Huang

Background: Pain and dysfunction of the shoulder and arm are prevalent among patients with breast cancer. This review aimed to evaluate current evidence regarding the effects of mirror therapy on pain, function, and quality of life in patients with breast cancer.

Methods: Five bibliographic databases in English and Chinese, PubMed, Embase, Scopus, CNKI, and Wanfang were searched from inception to May 15, 2024. Randomized controlled trials comparing the effects of mirror therapy to conventional treatment were eligible for inclusion. Methodological quality was assessed using the Physiotherapy Evidence Database (PEDro) scale. Meta-analyses were performed to determine the effects of mirror therapy.

Results: Four randomized controlled trials were included, with a total of 311 patients with breast cancer. All included studies were scored six to seven on the PEDro scale, indicating good quality. No adverse events related to mirror therapy were reported. Compared to conventional treatment, mirror therapy demonstrated significantly reduced pain (SMD: - 1.17, 95% CI: - 1.64 to - 0.70, p < 0.001), improved upper extremity function (SMD: 1.03, 95% CI: 0.05-2.02, p = 0.04), and enhanced quality of life (SMD: 0.43, 95% CI: 0.07-0.79, p = 0.02).

Conclusions: Mirror therapy is feasible and effective for upper extremity pain and dysfunction following breast cancer surgery. Clinicians may consider mirror therapy as an adjunctive intervention for breast cancer postoperative rehabilitation to advance the quality of care.

背景:肩臂疼痛和功能障碍在乳腺癌患者中很普遍。本综述旨在评估镜像疗法对乳腺癌患者疼痛、功能和生活质量影响的现有证据:方法:检索了从开始到 2024 年 5 月 15 日的五个中英文文献数据库:PubMed、Embase、Scopus、CNKI 和 Wanfang。将镜子疗法与传统疗法的效果进行比较的随机对照试验符合纳入条件。方法学质量采用物理治疗证据数据库(PEDro)量表进行评估。进行元分析以确定镜像疗法的效果:结果:共纳入了四项随机对照试验,涉及 311 名乳腺癌患者。所有纳入的研究在PEDro评分表中均被评为6至7分,表明研究质量良好。没有与镜像疗法相关的不良反应报告。与传统治疗相比,镜像疗法能显著减轻疼痛(SMD:- 1.17,95% CI:- 1.64 至 - 0.70,P 结论:镜像疗法是一种可行、有效的上臂乳腺癌治疗方法:镜像疗法对乳腺癌术后上肢疼痛和功能障碍的治疗是可行且有效的。临床医生可考虑将镜子疗法作为乳腺癌术后康复的辅助干预措施,以提高护理质量。
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引用次数: 0
Integrin β1 in breast cancer: mechanisms of progression and therapy. 乳腺癌中的整合素β1:进展和治疗机制。
IF 4 3区 医学 Q1 OBSTETRICS & GYNECOLOGY Pub Date : 2025-01-01 Epub Date: 2024-09-30 DOI: 10.1007/s12282-024-01635-w
Qionglian Huang, Jue Wang, Hanjuan Ning, Weiwei Liu, Xianghui Han

The therapy for breast cancer (BC), to date, still needs improvement. Apart from traditional therapy methods, biological therapy being explored opens up a novel avenue for BC patients. Integrin β1 (ITGβ1), one of the largest subgroups in integrin family, is a key player in cancer evolution and therapy. Recent researches progress in the relationship of ITGβ1 level and BC, finding that ITGβ1 expression evidently concerns BC progression. In this chapter, we outline diverse ITGβ1-based mechanisms regarding to the promoted effect of ITGβ1 on BC cell structure rearrangement and malignant phenotype behaviors, the unfavorable patient prognosis conferred by ITGβ1, BC therapy tolerance induced by ITGβ1, and lastly novel inhibitors targeting ITGβ1 for BC therapy. As an effective biomarker, ITGβ1 undoubtedly emerges one of targeted-therapy opportunities of BC patients in future. It is a necessity focusing on scientific and large-scale clinical trials on the validation of targeted-ITGβ1 drugs for BC patients.

迄今为止,乳腺癌(BC)的治疗方法仍有待改进。除了传统的治疗方法外,目前正在探索的生物疗法为乳腺癌患者开辟了一条新途径。整合素β1(ITGβ1)是整合素家族中最大的亚群之一,在癌症的演变和治疗中起着关键作用。近年来,关于 ITGβ1 水平与 BC 关系的研究取得了进展,发现 ITGβ1 的表达明显与 BC 的进展有关。在本章中,我们将概述基于ITGβ1的多种机制,包括ITGβ1对BC细胞结构重排和恶性表型行为的促进作用、ITGβ1对患者预后的不利影响、ITGβ1诱导的BC治疗耐受性,以及针对ITGβ1的新型BC治疗抑制剂。作为一种有效的生物标志物,ITGβ1无疑是未来BC患者靶向治疗的机会之一。因此,有必要对 ITGβ1 靶向药物进行科学验证和大规模临床试验。
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引用次数: 0
Liquid biopsy using non-coding RNAs and extracellular vesicles for breast cancer management. 利用非编码 RNA 和细胞外囊泡进行乳腺癌管理的液体活检。
IF 4 3区 医学 Q1 OBSTETRICS & GYNECOLOGY Pub Date : 2025-01-01 Epub Date: 2024-03-21 DOI: 10.1007/s12282-024-01562-w
Kazuki Hashimoto, Takahiro Ochiya, Akihiko Shimomura

This article examines liquid biopsy using non-coding RNAs and extracellular vesicles in detail. Liquid biopsy is emerging as a prominent non-invasive diagnostic tool in the treatment of breast cancer. We will elucidate the roles of these molecules in early detection, monitoring treatment effectiveness, and prognostic assessment of breast cancer. Additionally, the clinical significance of these molecules will be discussed. We aim to delve into the distinct characteristics of these molecules and their possible roles in breast cancer management, with an anticipation of their contribution to future diagnostic and therapeutic advancements.

本文详细探讨了利用非编码 RNA 和细胞外囊泡进行液体活检的方法。液体活检正在成为治疗乳腺癌的重要非侵入性诊断工具。我们将阐明这些分子在乳腺癌早期检测、治疗效果监测和预后评估中的作用。此外,我们还将讨论这些分子的临床意义。我们的目标是深入研究这些分子的独特特征及其在乳腺癌治疗中可能发挥的作用,并期待它们对未来诊断和治疗的进步做出贡献。
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引用次数: 0
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Breast Cancer
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