Breast Journal最新文献

Introduction: Breast cancer is the most common cancer among women globally, with 2.3 million new cases in 2020. Globally, incidence rates of breast cancer are highest in Australia, yet only 29% of Australian women opt for breast reconstruction (BR). The decision-making process for BR is complex, involving various surgical and nonsurgical considerations. Approximately 50% of women would choose BR if adequately informed and given the option. This study evaluates the factors contributing to reduced BR rates in regional and rural New South Wales over a 10-year period.

Methods: A multicentre, retrospective observational cohort study analysed 2052 women who were diagnosed with breast cancer in the Illawarra Shoalhaven Local Health District between 2012 and 2022, focussing on primary resection outcomes and other objective factors that contributed to BR rates. Descriptive statistics, chi-squared tests and logistic regression were used to assess relationships between age, comorbidities, language and rurality, with reconstruction rates.

Results: Among the 2052 women diagnosed with breast cancer who required oncologic resection, the mean age was 65 years. Only 127 (6.2%) underwent BR across the total cohort of 2052 patients, and just 65 of the 724 (9%) patients in the post-mastectomy subgroup underwent BR, significantly lower than state averages. Significant relationships were found between age and reconstruction rates (p < 0.001), with younger patients (< 55 years old) more likely to opt for BR. Logistic regression confirmed that increased age and rurality both significantly affected the likelihood of undergoing reconstruction.

Conclusion: Women aged < 55 years old and those residing in metropolitan areas showed a higher likelihood of opting for BR, highlighting the influence of age and rural residency on access to reconstruction services. These findings emphasise the need for targeted interventions to enhance BR access, particularly for older and rural patients.

Background: The lipofilled latissimus dorsi mini-flap (LDMF-L) broadens autologous breast-reconstruction options, yet its functional impact on the shoulder remains uncertain.

Objective: To evaluate shoulder strength, range of motion (ROM) and patient-reported upper-limb function QuickDash 90 days after breast reconstruction with the LDMF-L.

Methods: Prospective cohort of 20 patients operated on between November 2022 and November 2024. Inclusion: Breast cancer requiring immediate or delayed reconstruction with LDMF-L; exclusion: Implant use or major pre-existing limitation. Strength (Oxford scale), ROM (goniometry) and QuickDASH score were assessed preoperatively and at 90 days. Wilcoxon, Student's t-test, Mann-Whitney and McNemar tests were used appropriately (α = 0.05).

Results: Mean age 54 ± 11.8 years; immediate/delayed reconstruction = 50/50%. Strength remained unchanged in 85% (p = 1.000). Active flexion and abduction showed significant reductions (p = 0.016 and 0.045), with no difference in rotations. QuickDASH increased from 8 ± 16 to 19 ± 24 (p = 0.008); nevertheless, 80% stayed within minimal/mild disability.

Conclusions: The LDMF-L preserves strength and produces only mild early ROM decreases with limited functional impact, supporting its functional safety as an implant-free autologous option.

Background: Breast cancer is the most commonly diagnosed malignancy among women worldwide and a leading cause of cancer-related morbidity. As treatment advances have improved survival rates, symptom management has become a key component of comprehensive cancer care. Cancer-related symptoms often present in clusters rather than in isolation, potentially amplifying patient discomfort and negatively impacting quality of life. Identifying stage-specific symptom cluster patterns may provide critical insights for developing personalized supportive care strategies. This study aimed to identify and compare the prevalence, intensity, and discomfort of symptom clusters in women with Stage I and Stage III nonmetastatic breast cancer.

Method: This cross-sectional study included 87 women aged > 18 years with histopathological diagnoses of Stages I-III breast cancer, undergoing any phase of antineoplastic treatment at an oncology hospital in Brazil. Symptoms were assessed using the Memorial Symptom Assessment Scale (MSAS). The bootstrap resampling method was used to estimate 95% confidence intervals (CIs) for prevalence ratios (PRs) of MSAS symptoms, stratified by cancer stage. Symptom clusters were identified using hierarchical and k-means clustering analyses.

Results: Among Stage I patients, the most prevalent symptoms were pain (68.6%), worrying (62.8%), difficulty sleeping (62.8%), and fatigue (60.8%). In Stage III patients, the most frequent symptoms were pain (72.0%), fatigue (66.7%), worrying (63.9%), and dry mouth (50.0%). Stage I patients had a higher prevalence of difficulty concentrating (PR = 1.50; p = 0.015), shortness of breath (PR = 1.51; p < 0.001), feeling sad (PR = 1.41; p = 0.002), and hair loss (PR = 1.60; p = 0.037) compared to those with Stage III disease. Four clusters were identified for Stage I patients-neuropsychological, gastrointestinal, neurocognitive, and psychological-and for Stage III patients-psychoneurocognitive, gastrointestinal, chemotherapy-related, and neurocognitive.

Conclusion: These findings highlight the heterogeneity of symptom experiences in women with nonmetastatic breast cancer, with distinct cluster profiles emerging at different disease stages. Understanding stage-specific symptom patterns may inform more personalized and targeted supportive care strategies to improve quality of life and clinical outcomes in this population.

The transcription factor c-Myc is often overexpressed in chemotherapy-resistant triple-negative breast cancer (TNBC). c-Myc function and stability are considered key factors regulating chemoresistance. Recent studies have revealed a potential link between the O-linked β-N-acetylglucosamine modification (O-GlcNAcylation) of c-Myc and its function and stability; however, the underlying mechanisms remain unexplored. This study aimed to investigate the role of O-GlcNAcylation in promoting chemoresistance and to explore the underlying mechanisms. A cisplatin (DDP)-resistant MDA-MB-231 cell line was established using a dose escalation. CCK-8, flow cytometry, and colony formation assays were used to evaluate cell resistance under different treatments. Western blotting and coimmunoprecipitation analyses were performed to evaluate the expression of c-Myc and its O-GlcNAcylation under different conditions. The possible O-GlcNAcylation sites were predicted using DictyOGlyc 1.1. Inhibition of O-linked N-acetylglucosamine transferase (OGT) significantly suppressed colony formation and promoted apoptosis of DDP-resistant cells. c-Myc expression was downregulated when OGT-mediated O-GlcNAcylation was inhibited. Additionally, OGT interacted with c-Myc, promoting its stability at the Thr58 residue. Mutation of Thr58 not only resulted in lower c-Myc stability, reduced colony formation ability, and increased apoptosis but also resulted in a decrease in both the total expression and O-GlcNAcylation of c-Myc. Therefore, O-GlcNAcylation at Thr-58 regulates c-Myc activity to promote chemoresistance of TNBC cells.