Pub Date : 2025-12-01DOI: 10.1016/j.breast.2025.104603
Karen Gelmon , Cynthia Villarreal-Garza , Dawn Aubel , Hope S. Rugo , Julia Maués , Luzia Travado , Matthijs Van Meerveld , Runcie C.W. Chidebe , Bianca Patel , Georgia Attfield , Alexandra Lewis , Fatima Cardoso
Progress in the treatment landscape for advanced breast cancer (ABC) has significantly extended the survival of people with the disease. However, longevity alone is insufficient; maintaining and enhancing quality of life (QoL) is vital to ensure that people with ABC experience not only longer lives but fulfilling ones. Literature consistently highlights the unmet psychosocial needs of people with ABC, and its negative impact on QoL. Furthermore, many awareness and support programs disproportionately focus on early breast cancer, resulting in substantial gaps in information, resources, and medical and psychological support for people with ABC, which in turn can exacerbate feelings of isolation and stigma.
This manuscript explores the impact of ABC on QoL and draws on research conducted for the development of the ABC Global Alliance's Global Decade Report 2.0. The main findings are: a) QoL improvements over the last decade vary between ABC subtypes, with triple negative ABC patients having the lowest QoL; b) The impact of ABC on QoL remains unequal between populations; c) Low-grade side effects of ABC treatment have a profound impact on QoL; d) ABC has a substantial impact on caregiver QoL; e) Many QoL assessment tools currently fail to capture the specific needs of people with ABC.
The findings from the ABC Global Alliance's Global Decade Report 2.0 have informed the development of a new ABC Global Charter. The ABC Global Charter 2.0 defines ten new achievable and measurable goals for the decade 2025–2035, aiming at improving the lives of people living with ABC worldwide.
{"title":"Improving the quality of life of people with advanced breast cancer: a global expert review and call-to-action for 2025–2035 (goal 3)","authors":"Karen Gelmon , Cynthia Villarreal-Garza , Dawn Aubel , Hope S. Rugo , Julia Maués , Luzia Travado , Matthijs Van Meerveld , Runcie C.W. Chidebe , Bianca Patel , Georgia Attfield , Alexandra Lewis , Fatima Cardoso","doi":"10.1016/j.breast.2025.104603","DOIUrl":"10.1016/j.breast.2025.104603","url":null,"abstract":"<div><div>Progress in the treatment landscape for advanced breast cancer (ABC) has significantly extended the survival of people with the disease. However, longevity alone is insufficient; maintaining and enhancing quality of life (QoL) is vital to ensure that people with ABC experience not only longer lives but fulfilling ones. Literature consistently highlights the unmet psychosocial needs of people with ABC, and its negative impact on QoL. Furthermore, many awareness and support programs disproportionately focus on early breast cancer, resulting in substantial gaps in information, resources, and medical and psychological support for people with ABC, which in turn can exacerbate feelings of isolation and stigma.</div><div>This manuscript explores the impact of ABC on QoL and draws on research conducted for the development of the ABC Global Alliance's Global Decade Report 2.0. The main findings are: a) QoL improvements over the last decade vary between ABC subtypes, with triple negative ABC patients having the lowest QoL; b) The impact of ABC on QoL remains unequal between populations; c) Low-grade side effects of ABC treatment have a profound impact on QoL; d) ABC has a substantial impact on caregiver QoL; e) Many QoL assessment tools currently fail to capture the specific needs of people with ABC.</div><div>The findings from the ABC Global Alliance's Global Decade Report 2.0 have informed the development of a new ABC Global Charter. The ABC Global Charter 2.0 defines ten new achievable and measurable goals for the decade 2025–2035, aiming at improving the lives of people living with ABC worldwide.</div></div>","PeriodicalId":9093,"journal":{"name":"Breast","volume":"84 ","pages":"Article 104603"},"PeriodicalIF":7.9,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145620736","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-01DOI: 10.1016/j.breast.2025.104604
Belinda Kiely , Luzia Travado , Andrea L. Smith , Isabelle Aloi Timeus , Sung-Bae Kim , Renate Haidinger , Nampak N M Nanre , Hope Rugo , Georgia Attfield , Alexandra Lewis , Fatima Cardoso
Advanced breast cancer (ABC) represents a significant global health challenge, not only due to its high mortality rates but also because of the profound physical, emotional, and social burden it imposes on patients. Support services – encompassing psychological, social and peer support, complementary and integrative therapies, wellness and lifestyle support, genetic counseling, survivorship programs, palliative and end-of-life care – are essential to addressing these challenges and ensuring that individuals with ABC receive holistic, person-centered care throughout their disease journey.
This manuscript outlines the need for universal access to comprehensive, tailored support services to transform the landscape of ABC care, improve quality of life, and promote health equity globally. It summarizes research conducted for the ABC Global Alliance's Global Decade Report 2.0. The main findings are: a) More than half of people with ABC report never being offered support services; b) Global disparities in ABC support services persist despite policy recommendations from national cancer care plans; c) Global survey data show major gaps in ABC support service referral and utilization; d) Palliative care remains underutilized and often introduced too late in ABC care; e) Despite growth of ABC advocacy groups, healthcare provider referrals are limited.
The findings from the ABC Global Alliance's Global Decade Report 2.0 have informed the development of a new ABC Global Charter. The ABC Global Charter 2.0 defines ten new achievable and measurable goals for the decade 2025–2035, aiming at improving the lives of people living with ABC worldwide.
{"title":"Increasing awareness of and referral to support services in advanced breast cancer: a global expert review and call-to-action for 2025–2035 (Goal 7)","authors":"Belinda Kiely , Luzia Travado , Andrea L. Smith , Isabelle Aloi Timeus , Sung-Bae Kim , Renate Haidinger , Nampak N M Nanre , Hope Rugo , Georgia Attfield , Alexandra Lewis , Fatima Cardoso","doi":"10.1016/j.breast.2025.104604","DOIUrl":"10.1016/j.breast.2025.104604","url":null,"abstract":"<div><div>Advanced breast cancer (ABC) represents a significant global health challenge, not only due to its high mortality rates but also because of the profound physical, emotional, and social burden it imposes on patients. Support services – encompassing psychological, social and peer support, complementary and integrative therapies, wellness and lifestyle support, genetic counseling, survivorship programs, palliative and end-of-life care – are essential to addressing these challenges and ensuring that individuals with ABC receive holistic, person-centered care throughout their disease journey.</div><div>This manuscript outlines the need for universal access to comprehensive, tailored support services to transform the landscape of ABC care, improve quality of life, and promote health equity globally. It summarizes research conducted for the ABC Global Alliance's Global Decade Report 2.0. The main findings are: a) More than half of people with ABC report never being offered support services; b) Global disparities in ABC support services persist despite policy recommendations from national cancer care plans; c) Global survey data show major gaps in ABC support service referral and utilization; d) Palliative care remains underutilized and often introduced too late in ABC care; e) Despite growth of ABC advocacy groups, healthcare provider referrals are limited.</div><div>The findings from the ABC Global Alliance's Global Decade Report 2.0 have informed the development of a new ABC Global Charter. The ABC Global Charter 2.0 defines ten new achievable and measurable goals for the decade 2025–2035, aiming at improving the lives of people living with ABC worldwide.</div></div>","PeriodicalId":9093,"journal":{"name":"Breast","volume":"84 ","pages":"Article 104604"},"PeriodicalIF":7.9,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145620743","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-01DOI: 10.1016/j.breast.2025.104612
Alexandru Eniu , Runcie C.W. Chidebe , Peter Vuylsteke , Mariana Chavez-MacGregor , Frederique Penault-Llorca , Gilberto Lopes , Matti Aapro , Silvia Neciosup , Nisha Pillay , Alexandra Lewis , Georgia Attfield , Fatima Cardoso
Advanced breast cancer (ABC) remains an incurable yet treatable disease, requiring lifelong care. While treatment advancements have extended survival for many patients, access to these innovations is far from universal. There remains a critical need to ensure equitable access to proven and established interventions for all individuals with ABC, while continuing to drive progress in care and survival outcomes.
This manuscript assesses the evolving economic landscape for and access to comprehensive ABC care since 2015. It describes the persistent access barriers and inequities, and outlines recommendations for the ABC community over the next decade. It summarizes research conducted for the ABC Global Alliance's Global Decade Report 2.0. The main findings are: a) Disparities in access to ABC care are widening globally; b) Variable access to diagnostic services delays timely and adequate ABC treatment; c) Infrastructure, supply, and reimbursement barriers hinder ABC treatment access; d) High out-of-pocket costs drive severe financial toxicity across all income settings; e) In low-income contexts, multi-stakeholder efforts are improving access to ABC care.
The findings from the ABC Global Alliance's Global Decade Report 2.0 have informed the development of a new ABC Global Charter. The ABC Global Charter 2.0 defines ten new achievable and measurable goals for the decade 2025–2035, aiming at improving the lives of people living with ABC worldwide.
{"title":"Improving equitable access to comprehensive care for people with advanced breast cancer: a global expert review and call-to-action for 2025–2035 (Goal 9)","authors":"Alexandru Eniu , Runcie C.W. Chidebe , Peter Vuylsteke , Mariana Chavez-MacGregor , Frederique Penault-Llorca , Gilberto Lopes , Matti Aapro , Silvia Neciosup , Nisha Pillay , Alexandra Lewis , Georgia Attfield , Fatima Cardoso","doi":"10.1016/j.breast.2025.104612","DOIUrl":"10.1016/j.breast.2025.104612","url":null,"abstract":"<div><div>Advanced breast cancer (ABC) remains an incurable yet treatable disease, requiring lifelong care. While treatment advancements have extended survival for many patients, access to these innovations is far from universal. There remains a critical need to ensure equitable access to proven and established interventions for all individuals with ABC, while continuing to drive progress in care and survival outcomes.</div><div>This manuscript assesses the evolving economic landscape for and access to comprehensive ABC care since 2015. It describes the persistent access barriers and inequities, and outlines recommendations for the ABC community over the next decade. It summarizes research conducted for the ABC Global Alliance's Global Decade Report 2.0. The main findings are: a) Disparities in access to ABC care are widening globally; b) Variable access to diagnostic services delays timely and adequate ABC treatment; c) Infrastructure, supply, and reimbursement barriers hinder ABC treatment access; d) High out-of-pocket costs drive severe financial toxicity across all income settings; e) In low-income contexts, multi-stakeholder efforts are improving access to ABC care.</div><div>The findings from the ABC Global Alliance's Global Decade Report 2.0 have informed the development of a new ABC Global Charter. The ABC Global Charter 2.0 defines ten new achievable and measurable goals for the decade 2025–2035, aiming at improving the lives of people living with ABC worldwide.</div></div>","PeriodicalId":9093,"journal":{"name":"Breast","volume":"84 ","pages":"Article 104612"},"PeriodicalIF":7.9,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145620742","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-01DOI: 10.1016/j.breast.2025.104607
Mariana Chavez-MacGregor , Joseph Gligorov , João Mouta , Matthijs Van Meerveld , Zsofia Wolkensdorfer , Georgia Attfield , Alexandra Lewis , Fatima Cardoso
Advanced breast cancer (ABC) remains a significant public health challenge, accounting for the majority of the ∼670,000 breast cancer deaths globally in 2022. In the past decade, significant improvements in survival were seen across all ABC subtypes and patient populations, but disparities remain and ABC continues to be an incurable disease for most people.
This manuscript provides an overview of the survival improvements reported for each ABC subtype in clinical trials and in real-world studies since 2015. It highlights where disparities remain and outlines recommendations for the ABC community over the next decade to further improve survival. It summarizes findings from reviews conducted for the ABC Global Alliance's Global Decade Report 2.0. The main findings are: a) Clinical trials showed significant survival gains for ABC in 2015–2025, particularly for hormone receptor-positive and human epidermal growth factor 2 receptor (HER2)-positive subtypes; b) Real-world data mirrors survival trends seen in ABC clinical trials; c) Biomarker-driven treatments offer benefits in ABC, but testing is inconsistent from healthcare professionals; d) Survival disparities remain between ABC subtypes; e) Survival in ABC remains poor compared to early breast cancer.
The findings from the ABC Global Alliance's Global Decade Report 2.0 have informed the development of a new ABC Global Charter. The ABC Global Charter 2.0 defines ten new achievable and measurable goals for the decade 2025–2035, aiming at improving the lives of people living with ABC worldwide.
{"title":"Improving survival outcomes of people with ABC: a global expert review and call-to-action for 2025–2035 (Goal 1)","authors":"Mariana Chavez-MacGregor , Joseph Gligorov , João Mouta , Matthijs Van Meerveld , Zsofia Wolkensdorfer , Georgia Attfield , Alexandra Lewis , Fatima Cardoso","doi":"10.1016/j.breast.2025.104607","DOIUrl":"10.1016/j.breast.2025.104607","url":null,"abstract":"<div><div>Advanced breast cancer (ABC) remains a significant public health challenge, accounting for the majority of the ∼670,000 breast cancer deaths globally in 2022. In the past decade, significant improvements in survival were seen across all ABC subtypes and patient populations, but disparities remain and ABC continues to be an incurable disease for most people.</div><div>This manuscript provides an overview of the survival improvements reported for each ABC subtype in clinical trials and in real-world studies since 2015. It highlights where disparities remain and outlines recommendations for the ABC community over the next decade to further improve survival. It summarizes findings from reviews conducted for the ABC Global Alliance's Global Decade Report 2.0. The main findings are: a) Clinical trials showed significant survival gains for ABC in 2015–2025, particularly for hormone receptor-positive and human epidermal growth factor 2 receptor (HER2)-positive subtypes; b) Real-world data mirrors survival trends seen in ABC clinical trials; c) Biomarker-driven treatments offer benefits in ABC, but testing is inconsistent from healthcare professionals; d) Survival disparities remain between ABC subtypes; e) Survival in ABC remains poor compared to early breast cancer.</div><div>The findings from the ABC Global Alliance's Global Decade Report 2.0 have informed the development of a new ABC Global Charter. The ABC Global Charter 2.0 defines ten new achievable and measurable goals for the decade 2025–2035, aiming at improving the lives of people living with ABC worldwide.</div></div>","PeriodicalId":9093,"journal":{"name":"Breast","volume":"84 ","pages":"Article 104607"},"PeriodicalIF":7.9,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145619945","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-01DOI: 10.1016/j.breast.2025.104601
Fatima Cardoso , Roberta Ventura , Georgia Attfield , Alexandra Lewis , Karen Gelmon
Breast cancer remains one of the most significant global health challenges, with approximately 2.3 million new cases diagnosed and 666,000 deaths every year. Advanced breast cancer (ABC) – encompassing locally advanced and metastatic disease – represents the leading cause of breast cancer-related mortality and morbidity worldwide. While early-stage breast cancer has seen remarkable improvements in survival rates in the past decade, outcomes for individuals with ABC remain sobering: only 32 % of women diagnosed with ABC survive five years post-diagnosis, and this figure drops to just 20 % for men.
The ABC Global Alliance was established in 2016 as a multi-stakeholder platform dedicated to advanced/metastatic breast cancer. Its vision: to improve and extend the lives of women and men living with ABC in all countries worldwide and to fight for a cure.
This special edition of The Breast is both a reflection on the past decade of progress across the ABC landscape, and a forward-looking roadmap for the future. It summarizes findings from the ABC Global Alliance's Global Decade Report 2.0 (2015–2025) and the newly defined ten goals set out in the 2025–2035 ABC Global Charter 2.0, signaling a renewed commitment to advancing ABC care globally over the next decade.
{"title":"Knowledge in Motion: A decade reviewed, a future defined – The ABC Global Alliance 2015–2025 Decade Report and 2025–2035 Global Charter","authors":"Fatima Cardoso , Roberta Ventura , Georgia Attfield , Alexandra Lewis , Karen Gelmon","doi":"10.1016/j.breast.2025.104601","DOIUrl":"10.1016/j.breast.2025.104601","url":null,"abstract":"<div><div>Breast cancer remains one of the most significant global health challenges, with approximately 2.3 million new cases diagnosed and 666,000 deaths every year. Advanced breast cancer (ABC) – encompassing locally advanced and metastatic disease – represents the leading cause of breast cancer-related mortality and morbidity worldwide. While early-stage breast cancer has seen remarkable improvements in survival rates in the past decade, outcomes for individuals with ABC remain sobering: only 32 % of women diagnosed with ABC survive five years post-diagnosis, and this figure drops to just 20 % for men.</div><div>The ABC Global Alliance was established in 2016 as a multi-stakeholder platform dedicated to advanced/metastatic breast cancer. Its vision: to improve and extend the lives of women and men living with ABC in all countries worldwide and to fight for a cure.</div><div>This special edition of <em>The Breast</em> is both a reflection on the past decade of progress across the ABC landscape, and a forward-looking roadmap for the future. It summarizes findings from the ABC Global Alliance's Global Decade Report 2.0 (2015–2025) and the newly defined ten goals set out in the 2025–2035 ABC Global Charter 2.0, signaling a renewed commitment to advancing ABC care globally over the next decade.</div></div>","PeriodicalId":9093,"journal":{"name":"Breast","volume":"84 ","pages":"Article 104601"},"PeriodicalIF":7.9,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145620735","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-01DOI: 10.1016/j.breast.2025.104608
Vicki Durston , Charlotte E. Coles , Adele Gautier , Andrea L. Smith , Alexandra Lewis , Georgia Attfield , Fatima Cardoso
The systematic collection and analysis of high-quality advanced breast cancer (ABC) data is necessary to advance understanding, optimize care, and improve patient outcomes. High-quality data enables understanding of treatment effectiveness, thereby facilitating the development of innovative therapies. ABC data may also help to counter stigma, by demonstrating that many living with the disease continue to contribute meaningfully to society. Data is an essential tool in highlighting global inequities and advocating to overcome them, and prevalence data is key to determining the burden of ABC worldwide, informing healthcare policies and investment in ABC care.
This manuscript reviews global efforts to improve the collection and analysis of ABC data over the past decade. It highlights the advances and persistent challenges to high-quality data collection and proposes actions for the decade ahead. It summarizes research conducted for the ABC Global Alliance's Global Decade Report 2.0. The main findings are: a) New methodologies yield more accurate estimates of the number of people with ABC; b) Data linkage initiatives reveal ABC prevalence far higher than earlier projections; c) ABC-focused registries have advanced data collection globally over the decade; d) High-quality ABC data has been shown to drive treatment access and policy change; e) Persistent gaps in recurrence data and registries remain.
The findings from the ABC Global Alliance's Global Decade Report 2.0 have informed the development of a new ABC Global Charter. The ABC Global Charter 2.0 defines ten new achievable and measurable goals for the decade 2025–2035, aiming at improving the lives of people living with ABC worldwide.
{"title":"Collecting high-quality data for advanced breast cancer: a global expert review and call-to-action for 2025–2035 (Goal 2)","authors":"Vicki Durston , Charlotte E. Coles , Adele Gautier , Andrea L. Smith , Alexandra Lewis , Georgia Attfield , Fatima Cardoso","doi":"10.1016/j.breast.2025.104608","DOIUrl":"10.1016/j.breast.2025.104608","url":null,"abstract":"<div><div>The systematic collection and analysis of high-quality advanced breast cancer (ABC) data is necessary to advance understanding, optimize care, and improve patient outcomes. High-quality data enables understanding of treatment effectiveness, thereby facilitating the development of innovative therapies. ABC data may also help to counter stigma, by demonstrating that many living with the disease continue to contribute meaningfully to society. Data is an essential tool in highlighting global inequities and advocating to overcome them, and prevalence data is key to determining the burden of ABC worldwide, informing healthcare policies and investment in ABC care.</div><div>This manuscript reviews global efforts to improve the collection and analysis of ABC data over the past decade. It highlights the advances and persistent challenges to high-quality data collection and proposes actions for the decade ahead. It summarizes research conducted for the ABC Global Alliance's Global Decade Report 2.0. The main findings are: a) New methodologies yield more accurate estimates of the number of people with ABC; b) Data linkage initiatives reveal ABC prevalence far higher than earlier projections; c) ABC-focused registries have advanced data collection globally over the decade; d) High-quality ABC data has been shown to drive treatment access and policy change; e) Persistent gaps in recurrence data and registries remain.</div><div>The findings from the ABC Global Alliance's Global Decade Report 2.0 have informed the development of a new ABC Global Charter. The ABC Global Charter 2.0 defines ten new achievable and measurable goals for the decade 2025–2035, aiming at improving the lives of people living with ABC worldwide.</div></div>","PeriodicalId":9093,"journal":{"name":"Breast","volume":"84 ","pages":"Article 104608"},"PeriodicalIF":7.9,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145620737","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-01DOI: 10.1016/j.breast.2025.104558
Leonor Matos , Mette van Ramshorst , Volkmar Müller , Elisa Agostinetto , Sabine Linn , Matteo Lambertini , Veronique Dieras , Fanny le Du , Sofia Braga , Carmen Criscitiello , Katarzyna J. Jerzak , Gil Morgan , Sara Brucker , Patricia von Kroge , Renate Haidinger , Gema Rodríguez Recio , Eva Schumacher-Wulf , Mario Fontes Sousa , Francesco Schettini , Elena Laakmann
Background
Routine brain imaging screening (BIS) in patients with metastatic breast cancer (BC) without neurological symptoms is currently not recommended, as no survival/quality-of-life improvements have been demonstrated. We aimed to examine physicians and patients’ attitudes and perceptions toward BIS.
Methods
International cross-sectional online survey for patients and physicians, distributed from May 2023 to February 2024. Patients with BC diagnosis were deemed eligible for patients' survey completion and BC-treating physicians were invited to fill the physicians’ questionnaire.
Results
A total of 529 physicians from 50 countries (80 % European) responded, mostly medical oncologists (70 %) working in academic hospitals (53 %). Most physicians request BIS (65 %), mainly when extracranial progression occurs, especially for HER2+ and triple negative BC (TNBC). Among physicians never performing BIS (35 %), 91 % would in case of proved clinical benefit. A total of 545 patients from 14 European countries completed the questionnaire. Median age was 50 years, 86 % had metastatic BC, 51 % hormone receptor-positive (HR+)/HER2-negative, 30 % HER2-positive (HER2+) and 19 % TNBC. BM were diagnosed in 11.5 % patients with metastatic BC. 85 % patients would like to undergo BIS, especially younger ones (p = 0.02) and with HR-disease (p = 0.03), despite the uncertain clinical benefit. Notably, 91 % of patients would like to receive information regarding BM, while only 13 % of physicians routinely address the issue.
Conclusions
These results underline the willingness of patients to know more about the prospects of BM development, in contrast to the lack of routine discussion of this topic by physicians. Further investigation is warranted to demonstrate the clinical utility of routine BIS.
{"title":"Brain imaging screening in metastatic breast cancer: patients’ and physicians’ perspectives","authors":"Leonor Matos , Mette van Ramshorst , Volkmar Müller , Elisa Agostinetto , Sabine Linn , Matteo Lambertini , Veronique Dieras , Fanny le Du , Sofia Braga , Carmen Criscitiello , Katarzyna J. Jerzak , Gil Morgan , Sara Brucker , Patricia von Kroge , Renate Haidinger , Gema Rodríguez Recio , Eva Schumacher-Wulf , Mario Fontes Sousa , Francesco Schettini , Elena Laakmann","doi":"10.1016/j.breast.2025.104558","DOIUrl":"10.1016/j.breast.2025.104558","url":null,"abstract":"<div><h3>Background</h3><div>Routine brain imaging screening (BIS) in patients with metastatic breast cancer (BC) without neurological symptoms is currently not recommended, as no survival/quality-of-life improvements have been demonstrated. We aimed to examine physicians and patients’ attitudes and perceptions toward BIS.</div></div><div><h3>Methods</h3><div>International cross-sectional online survey for patients and physicians, distributed from May 2023 to February 2024. Patients with BC diagnosis were deemed eligible for patients' survey completion and BC-treating physicians were invited to fill the physicians’ questionnaire.</div></div><div><h3>Results</h3><div>A total of 529 physicians from 50 countries (80 % European) responded, mostly medical oncologists (70 %) working in academic hospitals (53 %). Most physicians request BIS (65 %), mainly when extracranial progression occurs, especially for HER2+ and triple negative BC (TNBC). Among physicians never performing BIS (35 %), 91 % would in case of proved clinical benefit. A total of 545 patients from 14 European countries completed the questionnaire. Median age was 50 years, 86 % had metastatic BC, 51 % hormone receptor-positive (HR+)/HER2-negative, 30 % HER2-positive (HER2+) and 19 % TNBC. BM were diagnosed in 11.5 % patients with metastatic BC. 85 % patients would like to undergo BIS, especially younger ones (p = 0.02) and with HR-disease (p = 0.03), despite the uncertain clinical benefit. Notably, 91 % of patients would like to receive information regarding BM, while only 13 % of physicians routinely address the issue.</div></div><div><h3>Conclusions</h3><div>These results underline the willingness of patients to know more about the prospects of BM development, in contrast to the lack of routine discussion of this topic by physicians. Further investigation is warranted to demonstrate the clinical utility of routine BIS.</div></div>","PeriodicalId":9093,"journal":{"name":"Breast","volume":"84 ","pages":"Article 104558"},"PeriodicalIF":7.9,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144942450","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-01DOI: 10.1016/j.breast.2025.104582
Adam Ofri , Sze Ki Melanie Tam , Suki Gill , Andrew J. Spillane
{"title":"Corrigendum to “Current pattern of care in radiation therapy for DCIS in Australia - where are we heading?” [The Breast 82(2025) 104482]","authors":"Adam Ofri , Sze Ki Melanie Tam , Suki Gill , Andrew J. Spillane","doi":"10.1016/j.breast.2025.104582","DOIUrl":"10.1016/j.breast.2025.104582","url":null,"abstract":"","PeriodicalId":9093,"journal":{"name":"Breast","volume":"84 ","pages":"Article 104582"},"PeriodicalIF":7.9,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145181786","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-01DOI: 10.1016/j.breast.2025.104663
Georgia C. Wright , Luke T. Glover , Thomas J.E. Hubbard
Introduction
Neoadjuvant chemotherapy (NACT) is increasingly used in early breast cancer treatment and responses are highly variable. Accurate monitoring of tumour response is crucial for enabling precise surgical de-escalation, yet current methods are inadequate.
This systematic scoping review explores emerging technologies for predicting, monitoring, and diagnosing pre-operative breast cancer response to NACT.
Methods
A search of Embase, Medline, PubMed, and Cochrane databases was conducted until January 26, 2024. Studies investigating ability to detect tumour response during or after NACT, and prior to surgery, were included, and placed into 12 technology categories. Those investigating novel technologies were further categorised by Technology Readiness Level.
Results
From 2497 studies, 1329 met the inclusion criteria. 479/1329 (36 %) investigated conventional imaging; 19 % (253) investigated MRI, 5 % (64) mammography/ultrasound, 0.5 % (6) computed tomography, 0.4 % (5) digital breast tomosynthesis. Established technologies included gene panels (134/1329; 10 %) and post treatment core biopsy 35/1329; (3 %). 107/1329 (8 %) of studies developed nomograms based on routine clinical investigations, and 493/1329 (37 %) correlated established biomarkers e.g. Ki-67 with pathological response.
81 studies (6 %) addressed novel technologies, such as circulating nucleic acids (49/81), diffuse optical imaging (17/81), and elastography (15/81). A Technology Readiness Assessment revealed that all were between Technology Readiness Level 2 (Invention and Research) and 6 (Large Scale).
Conclusions
The majority of current research activity focuses on optimising existing technologies which may never provide the step change in diagnostic accuracy required to advance surgical de-escalation. Research activity should be focused on identifying effective novel technologies and driving translation into the clinical environment.
{"title":"Emerging technologies for monitoring breast cancer response to neoadjuvant chemotherapy: a systematic scoping review","authors":"Georgia C. Wright , Luke T. Glover , Thomas J.E. Hubbard","doi":"10.1016/j.breast.2025.104663","DOIUrl":"10.1016/j.breast.2025.104663","url":null,"abstract":"<div><h3>Introduction</h3><div>Neoadjuvant chemotherapy (NACT) is increasingly used in early breast cancer treatment and responses are highly variable. Accurate monitoring of tumour response is crucial for enabling precise surgical de-escalation, yet current methods are inadequate.</div><div>This systematic scoping review explores emerging technologies for predicting, monitoring, and diagnosing pre-operative breast cancer response to NACT.</div></div><div><h3>Methods</h3><div>A search of Embase, Medline, PubMed, and Cochrane databases was conducted until January 26, 2024. Studies investigating ability to detect tumour response during or after NACT, and prior to surgery, were included, and placed into 12 technology categories. Those investigating novel technologies were further categorised by Technology Readiness Level.</div></div><div><h3>Results</h3><div>From 2497 studies, 1329 met the inclusion criteria. 479/1329 (36 %) investigated conventional imaging; 19 % (253) investigated MRI, 5 % (64) mammography/ultrasound, 0.5 % (6) computed tomography, 0.4 % (5) digital breast tomosynthesis. Established technologies included gene panels (134/1329; 10 %) and post treatment core biopsy 35/1329; (3 %). 107/1329 (8 %) of studies developed nomograms based on routine clinical investigations, and 493/1329 (37 %) correlated established biomarkers e.g. Ki-67 with pathological response.</div><div>81 studies (6 %) addressed novel technologies, such as circulating nucleic acids (49/81), diffuse optical imaging (17/81), and elastography (15/81). A Technology Readiness Assessment revealed that all were between Technology Readiness Level 2 (Invention and Research) and 6 (Large Scale).</div></div><div><h3>Conclusions</h3><div>The majority of current research activity focuses on optimising existing technologies which may never provide the step change in diagnostic accuracy required to advance surgical de-escalation. Research activity should be focused on identifying effective novel technologies and driving translation into the clinical environment.</div></div>","PeriodicalId":9093,"journal":{"name":"Breast","volume":"85 ","pages":"Article 104663"},"PeriodicalIF":7.9,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145681782","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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