IF 5.7 2区医学 Q1 OBSTETRICS & GYNECOLOGY

Breast

Pub Date : 2025-02-01 DOI: 10.1016/j.breast.2025.103878

Sakhr Alshwayyat , Mahmoud Bashar Abu Al Hawa , Mustafa Alshwayyat , Tala Abdulsalam Alshwayyat , Siya sawan , Ghaith Heilat , Hanan M. Hammouri , Sara Mheid , Batool Al Shweiat , Hamdah Hanifa

Background

Breast adenoid cystic carcinoma (BACC) is a rare subtype of breast cancer that accounts for less than 0.1 % of all cases. This study was designed to assess the efficacy of various treatment approaches for BACC and to create the first web-based tool to facilitate personalized treatment decisions.

Methods

The Surveillance, Epidemiology, and End Results (SEER) database was used for this study's analysis. To identify the prognostic variables, we conducted Cox regression analysis and constructed prognostic models using five Machine Learning (ML) algorithms to predict the 5-year survival. A validation method incorporating the area under the curve (AUC) of the receiver operating characteristic (ROC) curve was used to validate the accuracy and reliability of ML models. We also performed a Kaplan-Meier (K-M) survival analysis.

Results

This study included 1212 patients. The median age was 60 years, with most tumors being localized and less than 2 cm in size. The 5-year overall survival (OS) rates were highest for surgery + radiotherapy (RT) (94.9 %) and lowest for surgery + chemotherapy (CTX) + RT (80.1 %). Positive estrogen receptor (ER) status and younger age were associated with better survival outcomes. ML models identified key predictive features for survival, including age, nodal status, and ER status.

Conclusion

Age, lymph node metastasis, and ER status are crucial prognostic indicators for BACC. Although postoperative RT enhances survival, the advantages of adjuvant CTX are uncertain, implying that it may be eschewed to avert adverse effects. Our online tool offers essential resources for prognostication and treatment optimization.

背景：乳腺腺样囊性癌（BACC）是一种罕见的乳腺癌亚型，占所有病例的不到0.1%。本研究旨在评估各种治疗方法对BACC的疗效，并创建第一个基于网络的工具，以促进个性化的治疗决策。方法：监测、流行病学和最终结果（SEER）数据库用于本研究的分析。为了确定预后变量，我们进行了Cox回归分析，并使用五种机器学习（ML）算法构建了预后模型来预测5年生存率。采用受试者工作特征（ROC）曲线下面积（AUC）验证方法验证ML模型的准确性和可靠性。我们还进行了Kaplan-Meier （K-M）生存分析。结果：本研究纳入1212例患者。中位年龄为60岁，大多数肿瘤是局部的，大小小于2厘米。手术+放疗（RT）组5年总生存率最高（94.9%），手术+化疗(CTX) + RT组5年总生存率最低（80.1%）。雌激素受体（ER）阳性和年龄越小生存率越高。ML模型确定了生存的关键预测特征，包括年龄、淋巴结状态和ER状态。结论：年龄、淋巴结转移和ER状态是BACC预后的重要指标。虽然术后放疗提高了生存率，但辅助CTX的优势尚不确定，这意味着可以避免它以避免不良反应。我们的在线工具为预测和治疗优化提供了必要的资源。

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引用次数: 0

Adverse health effects after breast cancer up to 14 years after diagnosis

IF 5.7 2区医学 Q1 OBSTETRICS & GYNECOLOGY

Breast

Pub Date : 2025-02-01 DOI: 10.1016/j.breast.2024.103865

Marianne J. Heins , Kelly M. de Ligt , Janneke Verloop , Sabine Siesling , Joke C. Korevaar , PSCCR group , Annette Berendsen , Daan Brandenbarg , Anneriet Dassen , Agnes Jager , Jacqueline Hugtenburg , Gerda van der Weele

Background

The number of breast cancer survivors increases, but information about long-term adverse health effects in breast cancer survivors is sparse. We aimed to get an overview of the health effects for which survivors visit their general practitioner up to 14 years after diagnosis.

Methods

We retrieved data on 11,495 women diagnosed with breast cancer in 2000–2016 and 23,242 age and sex matched controls from the PSCCR-Breast Cancer, a database containing data about cancer diagnosis, treatment and primary healthcare. We built Cox regression models for 685 health effects, with time until the health effect as the outcome and survivor/control and cancer treatment as predictors. Models were built separately for four age groups (aged 18/44, 45/59, 60/74 and 75/89) and two follow-up periods (1/4 and 5/14 years after diagnosis).

Results

148 health effects occurred statistically significantly more often in survivors than in controls (p < 0.05). Health effects varied by age, time since diagnosis and treatment, but osteoporosis, coughing, fatigue, skin and urinary infections, were statistically significantly increased in breast cancer survivors. Osteoporosis and chest symptoms were associated with hormone therapy; osteoporosis and skin infections with chemotherapy and lymphedema and skin infections with axillary dissection.

Conclusions

Breast cancer survivors may experience numerous adverse health effects up to 14 years after diagnosis. Insight in individual risks may assist healthcare professionals in managing patient expectations and improve monitoring, detection and treatment of adverse health effects.

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引用次数: 0

Corrigendum to ‘Adverse health effects after breast cancer up to 14 years after diagnosis’ [The Breast 61 (2022) 22–28]

IF 5.7 2区医学 Q1 OBSTETRICS & GYNECOLOGY

Breast

Pub Date : 2025-02-01 DOI: 10.1016/j.breast.2024.103864

Marianne J. Heins , Kelly M. de Ligt , Janneke Verloop , Sabine Siesling , Joke C. Korevaar , PSCCR group , Annette Berendsen , Daan Brandenbarg , Anneriet Dassen , Agnes Jager , Jacqueline Hugtenburg , Gerda van der Weele

引用次数: 0

Evaluating the impact of a tertiary multidisciplinary meeting in metastatic breast cancer: A prospective study 评估三级多学科会议对转移性乳腺癌的影响：一项前瞻性研究。

IF 5.7 2区医学 Q1 OBSTETRICS & GYNECOLOGY

Breast

Pub Date : 2025-02-01 DOI: 10.1016/j.breast.2024.103861

Belinda Sassé , Sammy Shaya , Jessica Nimmo , Katie Cao , Daphne Day , Katie Evans , Catherine Healy , Gwo-Yaw Ho , Gillian Kruss , Amelia McCartney , Linda Mojzisova , Ranjana Srivastava , Jennifer Tan , Mun Yee Tan , Kate Webber , Michelle White , Steven David , Marion Harris

Background

Metastatic breast cancer (mBC) guidelines recommend multidisciplinary meetings (MDM), but there is limited research on their impact. This prospective study examines the impact of an mBC MDM on management plans, their implementation rate, and costs and benefits at an Australian metropolitan breast cancer center.

Methods

Consecutive mBC MDM patients were enrolled. Oncologists recorded their management plans before the MDM. Following the MDM, consensus plan was recorded and compared to the pre-MDM plan. Plans were categorised as no change, low impact, or high impact. High impact was defined as major treatment change or trial referral. Plan implementation was assessed four months post-MDM. Co-primary endpoints were proportion of plans changed pre/post-MDM and the proportion of high vs. low-impact changes. Estimates of time spent on the MDM and time savings were collected.

Results

114 MDM presentations for 95 patients were recorded from October 2023 to July 2024. 65 (57.0 %) presentations resulted in a plan change (p < 0.001); 32 (28.1 %) were high impact (p < 0.001). Follow up data was collected for 77 presentations; 65 (84.4 %) were fully implemented. 42 presentations resulted in high impact recommendations, of which 39 were implemented (92.6 %) (p = 0.005). The MDM earned $571.18/week with estimated costs of $1584.63, a $1013.45 deficit. Costs were likely offset by estimated savings from improved clinic efficiencies.

Conclusion

MBC MDMs result in significant, actionable changes to patient management. 28.1 % of presentations resulted in treatment changes, almost all of which were implemented. Costs were offset by improved clinic efficiencies. MBC MDMs enhance care in this diverse patient population.

背景：转移性乳腺癌（mBC）指南推荐多学科会议（MDM），但对其影响的研究有限。本前瞻性研究考察了在澳大利亚一家大都市乳腺癌中心，mBC MDM对管理计划、执行率、成本和收益的影响。方法：纳入连续的mBC MDM患者。肿瘤医生在MDM之前记录了他们的管理计划。在MDM之后，记录共识计划，并与MDM之前的计划进行比较。计划被分为无变化、低影响和高影响。高影响定义为主要治疗改变或试验转诊。在mdm后4个月评估计划实施情况。共同主要终点是mdm前后计划改变的比例，以及高影响vs低影响变化的比例。收集了花费在MDM上的时间估计和节省的时间。结果：从2023年10月至2024年7月，记录了95例患者的114例MDM表现。65例（57.0%）报告导致计划改变(p结论：MBC MDMs对患者管理产生了显著的、可操作的变化。28.1%的报告导致治疗改变，几乎所有的治疗都得到了实施。诊所效率的提高抵消了费用。MBC MDMs增强了对这一多样化患者群体的护理。

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引用次数: 0

Survival feature and trend of female breast cancer: A comprehensive review of survival analysis from cancer registration data 女性乳腺癌的生存特征和趋势：来自癌症登记数据的生存分析的综合综述。

IF 5.7 2区医学 Q1 OBSTETRICS & GYNECOLOGY

Breast

Pub Date : 2025-02-01 DOI: 10.1016/j.breast.2024.103862

Dan-Dan Tang , Zhuo-Jun Ye , Wan-Wan Liu , Jing Wu , Jing-Yu Tan , Yan Zhang , Qun Xu , Yong-Bing Xiang

To better understand global patterns, chronological changes, and international comparisons of female breast cancer survival, we reviewed published data from population-based cancer registries worldwide. Using PubMed, Embase, Web of Science, SEER, and SinoMed, a comprehensive literature search was conducted for female breast cancer survival from the population-based cancer registries through 31 December 2023. Observed, relative, and net survival rates and their corresponding age-standardized survival rates since the 1990s were collected and further stratified by prognostic factors. The prognosis of female breast cancer patients was favorable, with 5-year relative survival rates above 80 % in most regions. The trend in breast cancer survival showed annual increases in most countries but was accompanied by geographical disparities. The highest age-standardized 5-year relative survival rate was identified in the USA (2010–2014) at 90.2 %, while the lowest was in India (2010–2014) at 66.1 %. Overall, North America and Oceania had the best survival, and, for Europe, survival was worst in Eastern Europe. The survival in some Asian countries was disturbing. Younger age groups had a better prognosis than those aged 75 years and over. The lowest survival rates were observed in patients with distant metastatic and triple-negative breast cancer. Worldwide, there has been a steady improvement in female breast cancer survival. However, the survival gap between developed and developing countries has remained wide over the past 30 years. Differences in age, stage at diagnosis, and molecular subtype may explain some of the disparities, providing evidence for targeted management strategies.

为了更好地了解女性乳腺癌生存的全球模式、时间变化和国际比较，我们回顾了全球基于人群的癌症登记处发表的数据。使用PubMed、Embase、Web of Science、SEER和SinoMed，对截至2023年12月31日基于人群的癌症登记处的女性乳腺癌生存率进行了全面的文献检索。收集自20世纪90年代以来的观察、相对和净生存率及其相应的年龄标准化生存率，并根据预后因素进一步分层。女性乳腺癌患者预后良好，多数地区5年相对生存率在80%以上。在大多数国家，乳腺癌生存率呈逐年上升趋势，但也存在地域差异。年龄标准化5年相对生存率最高的是美国（2010-2014），为90.2%，最低的是印度（2010-2014），为66.1%。总的来说，北美和大洋洲的存活率最高，而在欧洲，东欧的存活率最低。一些亚洲国家的生存状况令人不安。年龄较小的患者预后优于75岁及以上的患者。生存率最低的是远处转移性乳腺癌和三阴性乳腺癌。在世界范围内，女性乳腺癌患者的存活率稳步提高。然而，在过去30年里，发达国家和发展中国家之间的生存差距仍然很大。年龄、诊断阶段和分子亚型的差异可以解释一些差异，为有针对性的管理策略提供证据。

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引用次数: 0

Beyond Hormone Receptors: liquid biopsy tools to unveil new clinical meanings and empower therapeutic decision-making in Luminal-like metastatic breast cancer 超越激素受体：液体活检工具揭示新的临床意义，并赋予luminal样转移性乳腺癌的治疗决策。

IF 5.7 2区医学 Q1 OBSTETRICS & GYNECOLOGY

Breast

Pub Date : 2025-02-01 DOI: 10.1016/j.breast.2024.103859

Brenno Pastò , Riccardo Vida , Arianna Dri , Lorenzo Foffano , Serena Della Rossa , Lorenzo Gerratana , Fabio Puglisi

Immunohistochemical (IHC) tissue profiling is a standard practice in the management of metastatic breast cancer (mBC), that enables the identification of distinct biological phenotypes based on hormone receptors' expression. Luminal-like tumors primarily benefit from a first line treatment strategy combining endocrine therapy and cyclin-dependent kinase 4/6 inhibitors. However, IHC analyses necessitate invasive procedures and may encounter technical and interpretational challenges. In the current era of precision medicine, liquid biopsy holds potential to provide clinicians with additional insights into disease biology, including mechanisms underlying endocrine resistance and disease progression. Several liquid-based biomarkers are entering clinical practice and hold prognostic and predictive values in Luminal-like mBC, while many others are currently being investigated. The present work aims to summarize the current evidence regarding the clinical meanings of hormone receptors and their downstream molecular pathways, alongside their implications for therapeutic decision-making in Luminal-like mBC.

免疫组织化学（IHC）组织谱分析是转移性乳腺癌（mBC）治疗的标准做法，可以根据激素受体的表达识别不同的生物表型。发光样肿瘤主要受益于一线治疗策略结合内分泌治疗和周期蛋白依赖性激酶4/6抑制剂。然而，免疫组化分析需要侵入性程序，并且可能遇到技术和解释上的挑战。在当前的精准医学时代，液体活检有可能为临床医生提供更多关于疾病生物学的见解，包括内分泌抵抗和疾病进展的机制。几种基于液体的生物标志物正在进入临床实践，并在类似luminal的mBC中具有预后和预测价值，而其他许多生物标志物目前正在研究中。本研究旨在总结目前关于激素受体及其下游分子通路的临床意义的证据，以及它们对luminal样mBC治疗决策的影响。

{"title":"Beyond Hormone Receptors: liquid biopsy tools to unveil new clinical meanings and empower therapeutic decision-making in Luminal-like metastatic breast cancer","authors":"Brenno Pastò , Riccardo Vida , Arianna Dri , Lorenzo Foffano , Serena Della Rossa , Lorenzo Gerratana , Fabio Puglisi","doi":"10.1016/j.breast.2024.103859","DOIUrl":"10.1016/j.breast.2024.103859","url":null,"abstract":"<div><div>Immunohistochemical (IHC) tissue profiling is a standard practice in the management of metastatic breast cancer (mBC), that enables the identification of distinct biological phenotypes based on hormone receptors' expression. Luminal-like tumors primarily benefit from a first line treatment strategy combining endocrine therapy and cyclin-dependent kinase 4/6 inhibitors. However, IHC analyses necessitate invasive procedures and may encounter technical and interpretational challenges. In the current era of precision medicine, liquid biopsy holds potential to provide clinicians with additional insights into disease biology, including mechanisms underlying endocrine resistance and disease progression. Several liquid-based biomarkers are entering clinical practice and hold prognostic and predictive values in Luminal-like mBC, while many others are currently being investigated. The present work aims to summarize the current evidence regarding the clinical meanings of hormone receptors and their downstream molecular pathways, alongside their implications for therapeutic decision-making in Luminal-like mBC.</div></div>","PeriodicalId":9093,"journal":{"name":"Breast","volume":"79 ","pages":"Article 103859"},"PeriodicalIF":5.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142871294","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Raising awareness of alcohol as a modifiable risk factor for breast cancer: A randomized controlled trial comparing the efficacy of accessing an interactive website with a non-interactive website 提高对酒精作为乳腺癌可改变危险因素的认识：一项比较访问交互式网站和非交互式网站效果的随机对照试验。

IF 5.7 2区医学 Q1 OBSTETRICS & GYNECOLOGY

Breast

Pub Date : 2025-02-01 DOI: 10.1016/j.breast.2024.103868

Claudia Sardu , Fabrizio Angius , Paolo Contu , Sofia Cosentino , Monica Deiana , Matteo Fraschini , Clelia Madeddu , Elena Massa , Alessandra Mereu , Luigi Minerba , Carola Politi , Silvia Puxeddu , Francesco Salis , Julia M.A. Sinclair , Roberta Agabio

Background

Alcohol consumption is a potentially modifiable risk factor for breast cancer (BC). Reducing alcohol consumption within the daily amount at low-risk for alcohol-related consequences (daily alcohol threshold) may contribute to preventing BC new cases. However, most women are unaware of risk factors for BC, the daily alcohol threshold, and how to measure alcohol use. We aimed at investigating the efficacy of accessing an interactive website in increasing the knowledge that alcohol is a BC risk factor.

Methods

We conducted a randomized controlled trial among women waiting for mammography. Women completed a questionnaire to investigate their knowledge before and after accessing an interactive (intervention group) and non-interactive (control group) website.

Results

We recruited 671 women, randomized 329 (49.0 %) and 342 (51.0 %) to the intervention and control groups, respectively. At baseline, most women were not aware of most modifiable BC risk factors. Accessing either website significantly increased the percentage of women who acquired the knowledge on BC risk factors, with the interactive website achieving better results: 82 % and 69 % of women acquired the knowledge that alcohol is a risk factor for BC in the intervention and control groups, respectively (p < 0.001). Among women with lower levels of education, the probability of acquiring this knowledge was higher in the intervention group than control group.

Conclusion

Our results show that accessing an interactive website may increase the percentage of women who acquire the knowledge that alcohol is a BC risk factor especially among women of lower levels of education.

背景：饮酒是乳腺癌（BC）的一个潜在可改变的危险因素。在酒精相关后果低风险（每日酒精阈值）的情况下，减少每日饮酒量可能有助于预防BC新病例。然而，大多数女性不知道BC的危险因素、每日酒精阈值以及如何测量酒精使用。我们的目的是调查访问互动网站在增加酒精是不列颠哥伦比亚省危险因素的知识方面的功效。方法：我们在等待乳房x光检查的妇女中进行了一项随机对照试验。女性在访问互动式（干预组）和非互动式（对照组）网站前后完成了一份调查问卷。结果：我们招募了671名女性，随机分为干预组329名（49.0%）和对照组342名（51.0%）。在基线时，大多数妇女不知道大多数可改变的BC危险因素。访问任何一个网站都显著增加了获得BC危险因素知识的女性比例，互动网站取得了更好的结果：干预组和对照组中分别有82%和69%的女性获得了酒精是BC危险因素的知识(p)。我们的研究结果表明，访问互动网站可能会增加女性了解酒精是不列颠哥伦比亚省风险因素的比例，特别是在受教育程度较低的女性中。

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引用次数: 0

Psychometric validation of the Danish BREAST-Q reconstruction module 丹麦BREAST-Q重构模块的心理计量学验证。

IF 5.7 2区医学 Q1 OBSTETRICS & GYNECOLOGY

Breast

Pub Date : 2025-02-01 DOI: 10.1016/j.breast.2025.103872

Cecilie Balslev Willert , Karl Bang Christensen , Pernille Envold Bidstrup , Lene Mellemkjær , Anne-Marie Axø Gerdes , Lisbet Rosenkrantz Hölmich

Aim/background

Patient-reported outcome measurement instruments are important tools in understanding a breast reconstruction's impact on the patients' quality of life. A psychometric validation is essential before applying a patient-reported outcome measurement instrument in clinical practice and research. The BREAST-Q is a specific, validated questionnaire for breast surgery outcomes that has been translated from English to Danish. It consists of 167 items in 7 pre-operative scales and 15 post-operative scales. This validation study aims to validate the Danish BREAST-Q reconstruction module.

Material and methods

Eligible women were included from January 2019 to June 2020. Multiple-item scales with summated scores and more than 40 complete responses were eligible for psychometric validation, and psychometric analyses examined reliability and validity using Rasch Analyses and Classical Test Theory. Measurements included test for local response dependence, item fit, differential item functioning, and more. Clinical validity was assessed using known-groups hypotheses.

Results

We obtained 115 and 201 complete responses pre-and postoperatively, respectively. We validated 120 items in four preoperative and nine postoperative scales. The Rasch analyses disclosed evidence of local response dependence in eight scales. Chronbach's α ranged 0.81–0.95 after adjustment. Item fit was evaluated using item-restscore correlations and showed good fit in 98 % of items. Differential Item Functioning was found in four items but had very little effect on the model. Clinical validity was supported by the know-group analyses.

Discussion/conclusion

The Danish BREAST-Q reconstruction module has good acceptability, feasibility and validity, and adequate reliability. The results support the use in a Danish population.

目的/背景：患者报告的结果测量仪器是了解乳房重建对患者生活质量影响的重要工具。在临床实践和研究中应用患者报告的结果测量工具之前，心理测量验证是必不可少的。breast - q是一份针对乳房手术结果的特定、有效的问卷，已从英语翻译成丹麦语。包括7个术前量表和15个术后量表167个项目。本研究旨在验证丹麦BREAST-Q重建模块。材料和方法：2019年1月至2020年6月纳入符合条件的女性。包含总分和超过40个完整回答的多条目量表符合心理测量验证条件，心理测量分析使用Rasch分析和经典测试理论检验信度和效度。测量包括局部反应依赖性测试、项目契合度测试、差异项目功能测试等。采用已知群假设评估临床效度。结果：术前和术后分别获得115例和201例完全缓解。我们在术前4个量表和术后9个量表中验证了120个项目。Rasch的分析揭示了8个尺度上局部反应依赖的证据。调整后的Chronbach’s α为0.81 ~ 0.95。项目拟合使用项目-休息分数的相关性进行评估，并在98%的项目中显示良好的拟合。在四个项目中发现了差异项目功能，但对模型的影响很小。认知组分析支持临床效度。讨论/结论：丹麦BREAST-Q重建模块具有良好的可接受性、可行性和有效性，有足够的信度。结果支持在丹麦人群中使用。

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引用次数: 0

Genomic characterization and molecular predictive biomarkers for chemotherapy in patients with metastatic triple-negative breast cancer treated in a real-world setting 在现实世界中，转移性三阴性乳腺癌患者化疗的基因组特征和分子预测生物标志物。

IF 5.7 2区医学 Q1 OBSTETRICS & GYNECOLOGY

Breast

Pub Date : 2025-02-01 DOI: 10.1016/j.breast.2025.103874

Erik Olsson , Henrik Lindman , Evangelos Digkas , Viktoria Thurfjell , Haidar Mir Ali , Ute Krüger , Anna-Karin Wennstig , Marie Sundqvist , Antonios Valachis

Purpose

We aimed to characterize genomic alterations with potential prognostic or predictive significance in patients with metastatic triple-negative breast cancer (mTNBC) treated with chemotherapy in a real-world setting.

Patients and methods

Next-generation sequencing with FoundationOne® CDx was conducted primarily on primary tumor tissue from 112 consecutive patients with mTNBC. Genomic alterations were subdivided into canonical oncogenic pathways and noted for their involvement in homologous recombination deficiency (HRD). Altered genes and pathways were correlated with overall survival (OS) and evaluated regarding their association with real-world progression-free survival (rwPFS) in patients treated with different chemotherapy agents. Occurrence of alterations were compared between patients with exceptional response and rapid progression to chemotherapy.

Results

After exclusion due to insufficient tumor tissue or clinical data, material from 97 patients was analyzed. The most frequently altered genes were TP53 (82 %), RAD21 (25 %) and PIK3CA (23 %). Altogether, 26 % of patients had an alteration leading to HRD. None of the analyzed alterations were associated with OS. Variants leading to HRD were associated with a prolonged rwPFS in patients treated with platinum-based chemotherapy in the first line setting (hazard ratio [HR], 0.31 [95 % CI: 0.12–0.84]). Exceptional responders more often exhibited alterations in the MYC and RAS/RTK pathways compared to rapid progressors.

Conclusions

Patients with tumor alterations in HRD-related genes seem to define subgroups that respond favorably to platinum-based chemotherapy. Further research into the genomic landscape of tumors from patients with rapid progression or exceptional response to different treatment strategies can provide insights into mechanisms of resistance and identify predictive biomarkers.

目的：我们旨在描述在现实环境中接受化疗的转移性三阴性乳腺癌（mTNBC）患者具有潜在预后或预测意义的基因组改变。患者和方法：使用FoundationOne®CDx对112例连续mTNBC患者的原发肿瘤组织进行了新一代测序。基因组改变被细分为典型的致癌途径，并以其参与同源重组缺陷（HRD）而闻名。在接受不同化疗药物治疗的患者中，改变的基因和途径与总生存期（OS）相关，并评估了它们与真实世界无进展生存期（rwPFS）的关系。对化疗反应异常和进展迅速的患者进行比较。结果：在因肿瘤组织或临床资料不足而排除后，对97例患者的资料进行分析。最常见的改变基因是TP53（82%）、RAD21（25%）和PIK3CA（23%）。总的来说，26%的患者发生了导致HRD的改变。所分析的变化均与OS无关。在一线接受铂类化疗的患者中，导致HRD的变异与延长的rwPFS相关（风险比[HR]， 0.31 [95% CI: 0.12-0.84]）。与快速进展者相比，异常应答者更常表现出MYC和RAS/RTK通路的改变。结论：hrd相关基因肿瘤改变的患者似乎定义了对铂类化疗反应良好的亚组。对快速进展或对不同治疗策略有特殊反应的患者的肿瘤基因组景观的进一步研究可以提供对耐药机制的见解并确定预测性生物标志物。

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引用次数: 0

Retrospective comparative survival analysis of ablation plus systemic therapy versus systemic therapy alone for breast cancer liver metastases, stratified by extrahepatic metastases status 根据肝外转移状态分层，对乳腺癌肝转移灶进行消融加全身治疗与单独全身治疗的回顾性比较生存分析。

IF 5.7 2区医学 Q1 OBSTETRICS & GYNECOLOGY

Breast

Pub Date : 2025-02-01 DOI: 10.1016/j.breast.2025.103876

Xuxiazi Zou , Hong-Liang Zou , Xuan Luo , Xu-Wei Chen , Wei-Ling Huang , Chao Zhang , Ge Ren , Jin-Hua Huang , Xue Han , Yi-Quan Jiang

Background

Current decision-making for the treatment of breast cancer liver metastases (BCLM) using ablation lacks strong evidence, especially for patients combined with extrahepatic metastases.

Purpose

To assess whether ablation plus systemic therapy (AS) improves survival outcomes in patients with BCLM compared to systemic therapy alone.

Materials and methods

This retrospective study analyzed patients with BCLM who received either AS or systemic therapy alone. Propensity score matching (PSM) and survival analysis were performed, taking into account factors like the characteristics of primary breast cancer, liver metastases and systemic therapies received.

Results

The study included 1021 female patients, with a median follow-up of 39.6 months. Of these patients, 132 underwent AS and 836 received systemic therapy alone. After PSM, among patients with BCLM (≤3 tumors, each ≤3 cm), the median overall survival (OS) for those treated with AS or systemic therapy alone was 65.5 and 40.4 months, respectively (HR = 0.48, p = .003); in the subset of patients with extrahepatic metastases, the median OS for those treated with AS and systemic therapy alone was 46.4 and 40.8 months, respectively (HR = 0.58, p = .047). Among patients with >3 cm or >3 lesions, the median OS for those treated with AS or systemic therapy alone was 45.2 and 29 months, respectively (HR = 0.67, p = .084).

Conclusions

Among patients with BCLM (≤3 tumors, each ≤3 cm), AS provide longer survival compared to systemic therapy alone, even with extrahepatic metastases. For patients with larger or more numerous metastases (>3 cm or >3 lesions), AS may provide survival benefit, but further validation is needed.

背景：目前对于乳腺癌肝转移（BCLM）的消融治疗决策缺乏强有力的证据，特别是对于合并肝外转移的患者。目的：评估消融加全身治疗（AS）与单独全身治疗相比是否能改善BCLM患者的生存结果。材料和方法：本回顾性研究分析了单独接受AS或全身治疗的BCLM患者。考虑到原发性乳腺癌的特征、肝转移和接受的全身治疗等因素，进行倾向评分匹配（PSM）和生存分析。结果：纳入1021例女性患者，中位随访39.6个月。在这些患者中，132人接受了AS治疗，836人单独接受了全身治疗。PSM后，在BCLM（≤3个肿瘤，每个≤3 cm）患者中，单独接受AS或全身治疗的患者中位总生存期（OS）分别为65.5个月和40.4个月（HR = 0.48, p = 0.003）；在肝外转移患者亚组中，单独接受AS和全身治疗的患者的中位OS分别为46.4和40.8个月（HR = 0.58, p = 0.047）。在>3 cm或>3病变患者中，单独接受AS或全身治疗的中位OS分别为45.2个月和29个月（HR = 0.67, p = 0.084）。结论：在BCLM（≤3个肿瘤，每个≤3cm）患者中，AS比单独全身治疗提供更长的生存期，即使有肝外转移。对于更大或更多转移灶（bbb3cm或bbb3cm病变）的患者，AS可能提供生存获益，但需要进一步验证。

{"title":"Retrospective comparative survival analysis of ablation plus systemic therapy versus systemic therapy alone for breast cancer liver metastases, stratified by extrahepatic metastases status","authors":"Xuxiazi Zou , Hong-Liang Zou , Xuan Luo , Xu-Wei Chen , Wei-Ling Huang , Chao Zhang , Ge Ren , Jin-Hua Huang , Xue Han , Yi-Quan Jiang","doi":"10.1016/j.breast.2025.103876","DOIUrl":"10.1016/j.breast.2025.103876","url":null,"abstract":"<div><h3>Background</h3><div>Current decision-making for the treatment of breast cancer liver metastases (BCLM) using ablation lacks strong evidence, especially for patients combined with extrahepatic metastases.</div></div><div><h3>Purpose</h3><div>To assess whether ablation plus systemic therapy (AS) improves survival outcomes in patients with BCLM compared to systemic therapy alone.</div></div><div><h3>Materials and methods</h3><div>This retrospective study analyzed patients with BCLM who received either AS or systemic therapy alone. Propensity score matching (PSM) and survival analysis were performed, taking into account factors like the characteristics of primary breast cancer, liver metastases and systemic therapies received.</div></div><div><h3>Results</h3><div>The study included 1021 female patients, with a median follow-up of 39.6 months. Of these patients, 132 underwent AS and 836 received systemic therapy alone. After PSM, among patients with BCLM (≤3 tumors, each ≤3 cm), the median overall survival (OS) for those treated with AS or systemic therapy alone was 65.5 and 40.4 months, respectively (HR = 0.48, p = .003); in the subset of patients with extrahepatic metastases, the median OS for those treated with AS and systemic therapy alone was 46.4 and 40.8 months, respectively (HR = 0.58, p = .047). Among patients with >3 cm or >3 lesions, the median OS for those treated with AS or systemic therapy alone was 45.2 and 29 months, respectively (HR = 0.67, p = .084).</div></div><div><h3>Conclusions</h3><div>Among patients with BCLM (≤3 tumors, each ≤3 cm), AS provide longer survival compared to systemic therapy alone, even with extrahepatic metastases. For patients with larger or more numerous metastases (>3 cm or >3 lesions), AS may provide survival benefit, but further validation is needed.</div></div>","PeriodicalId":9093,"journal":{"name":"Breast","volume":"79 ","pages":"Article 103876"},"PeriodicalIF":5.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11782866/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142982826","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

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