IF 7.9 2区医学 Q1 OBSTETRICS & GYNECOLOGY

Breast

Pub Date : 2025-12-11 DOI: 10.1016/j.breast.2025.104678

Tian Du , Jiayi Tang , Hanqi Zhang , Qianwen Liu, Yanan Kong

Background

Chronic stress and depression play critical roles in modulating breast cancer oncogenesis. Psychological stress-related genes can regulate tumor behavior and serve as prognostic factors. Here, we constructed a signature with psychological stress-related tumor genes to predict breast cancer survival and sensitivity to immunotherapy.

Methods

37 genes among the 374 psychological stress-related tumor genes were significantly associated with overall survival in The Cancer Genome Atlas (TCGA) and/or the Molecular Taxonomy of Breast Cancer International Consortium (METABRIC). The logistic least absolute shrinkage and selection operator (LASSO) regression was used to select genes to build the gene signature to predict overall survival. Area under the curve (AUC) and calibration curve were used to evaluate the performance of the prediction model. Pathway analysis and immune cell infiltration analysis were used to further understand the differences between tumors with high- and low-signature scores.

Results

18 psychological stress-related tumor genes were selected to construct the final signature. The AUCs were 0.764 and 0.646 for predicting 5-year overall survival in METABRIC and TCGA, slightly lower than the 10-year AUCs of 0.772 and 0.703. The Hosmer-Lemeshow goodness-of-fit test p-value of the model was 1, showing a good calibration performance. Low 18-gene signature score was associated with better prognosis, activated immune pathways, immune-active tumor microenvironment (TME) characterized by higher proportions of CD8⁺ T cells and NK cells, and better response to immunotherapy.

Conclusion

The 18-gene signature of literature reported psychological stress-related genes establishes a model with consistent performance for predicting clinical outcomes and captures immune activation, which could improve prognostic precision and predict immunotherapy response.

背景：慢性应激和抑郁在调节乳腺癌的发生中起关键作用。心理应激相关基因可调节肿瘤行为并作为预后因素。在这里，我们构建了一个与心理压力相关的肿瘤基因的特征来预测乳腺癌的生存和对免疫治疗的敏感性。方法：在癌症基因组图谱（TCGA）和/或乳腺癌国际分子分类学联盟（METABRIC）中，374个心理应激相关肿瘤基因中有37个基因与总生存显著相关。使用logistic最小绝对收缩和选择算子（LASSO）回归选择基因以构建基因标记以预测总生存。采用曲线下面积（AUC）和标定曲线对预测模型的性能进行评价。通过通路分析和免疫细胞浸润分析进一步了解高、低特征评分肿瘤之间的差异。结果：筛选出18个与心理应激相关的肿瘤基因构建最终签名。预测METABRIC和TCGA 5年总生存期的auc分别为0.764和0.646，略低于0.772和0.703的10年auc。模型的Hosmer-Lemeshow拟合优度检验p值为1，具有较好的标定性能。较低的18基因特征评分与较好的预后、激活的免疫途径、以CD8+ T细胞和NK细胞比例较高的免疫活性肿瘤微环境（TME）以及对免疫治疗的较好反应相关。结论：文献报道的心理应激相关基因的18个基因签名建立了一个具有一致性能的预测临床结果的模型，并捕获了免疫激活，可以提高预后精度和预测免疫治疗反应。

{"title":"A prognostic gene model with psychological stress-related genes captures immune activation in breast cancer","authors":"Tian Du , Jiayi Tang , Hanqi Zhang , Qianwen Liu, Yanan Kong","doi":"10.1016/j.breast.2025.104678","DOIUrl":"10.1016/j.breast.2025.104678","url":null,"abstract":"<div><h3>Background</h3><div>Chronic stress and depression play critical roles in modulating breast cancer oncogenesis. Psychological stress-related genes can regulate tumor behavior and serve as prognostic factors. Here, we constructed a signature with psychological stress-related tumor genes to predict breast cancer survival and sensitivity to immunotherapy.</div></div><div><h3>Methods</h3><div>37 genes among the 374 psychological stress-related tumor genes were significantly associated with overall survival in The Cancer Genome Atlas (TCGA) and/or the Molecular Taxonomy of Breast Cancer International Consortium (METABRIC). The logistic least absolute shrinkage and selection operator (LASSO) regression was used to select genes to build the gene signature to predict overall survival. Area under the curve (AUC) and calibration curve were used to evaluate the performance of the prediction model. Pathway analysis and immune cell infiltration analysis were used to further understand the differences between tumors with high- and low-signature scores.</div></div><div><h3>Results</h3><div>18 psychological stress-related tumor genes were selected to construct the final signature. The AUCs were 0.764 and 0.646 for predicting 5-year overall survival in METABRIC and TCGA, slightly lower than the 10-year AUCs of 0.772 and 0.703. The Hosmer-Lemeshow goodness-of-fit test p-value of the model was 1, showing a good calibration performance. Low 18-gene signature score was associated with better prognosis, activated immune pathways, immune-active tumor microenvironment (TME) characterized by higher proportions of CD8<sup>+</sup> T cells and NK cells, and better response to immunotherapy.</div></div><div><h3>Conclusion</h3><div>The 18-gene signature of literature reported psychological stress-related genes establishes a model with consistent performance for predicting clinical outcomes and captures immune activation, which could improve prognostic precision and predict immunotherapy response.</div></div>","PeriodicalId":9093,"journal":{"name":"Breast","volume":"85 ","pages":"Article 104678"},"PeriodicalIF":7.9,"publicationDate":"2025-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145910455","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}

引用次数: 0

Neoadjuvant endocrine therapy with sequential palbociclib and chemotherapy based on Ki67 status in stage II-III breast cancer: An open-label, phase II study 基于Ki67状态的II- iii期乳腺癌新辅助内分泌治疗与序贯帕博西尼和化疗：一项开放标签的II期研究

IF 7.9 2区医学 Q1 OBSTETRICS & GYNECOLOGY

Breast

Pub Date : 2025-12-10 DOI: 10.1016/j.breast.2025.104672

Christina Engebrethsen , Synnøve Yndestad , Mari E. Rasmussen , Emiel A.M. Janssen , Bjørnar Gilje , Egil S. Blix , Helge Espelid , Steinar Lundgren , Jürgen Geisler , Laura Minsaas , Reidun Lillestøl , Hildegunn S. Aase , Turid Aas , Per E. Lønning , Hans P. Eikesdal , Stian Knappskog

Background

While neoadjuvant endocrine therapy (NET), with or without a CDK4/6 inhibitor, is an established treatment option for estrogen receptor-positive breast cancers, optimal patient selection and second-line treatment for non-responders remain uncertain.

Methods

In the open-label, phase 2 PETREMAC trial (NCT02624973), pre- and postmenopausal patients with large T2 (>4 cm) or locally advanced ER/PGR>50 %, HER2-, and TP53 wild-type breast cancers received NET (tamoxifen + goserelin for premenopausal and letrozole for postmenopausal patients). Palbociclib was added if the Ki67 reduction was ≤50 % after 14 days. Neoadjuvant chemotherapy (NAC) was introduced if NET ± palbociclib failed to reduce Ki67 sufficiently or if there was no objective response on MRI after 24 weeks. Tumor biopsies underwent targeted sequencing of 360 cancer-related genes and subsequent gene expression profiling.

Results

Among 88 patients, the median tumor size was 48 mm (range 16–140 mm). NET alone reduced Ki67 > 50 % in 49/88 (56 %) of evaluable tumors. Adding palbociclib yielded a Ki67 reduction >50 % in 24/34 (71 %) of tumors where neoadjuvant endocrine therapy alone failed to suppress Ki67, providing a Ki67 reduction of >50 % in a total of 72/88 (82 %) of patients. NAC was administered to 34/88 (39 %) due to inadequate Ki67 response or lack of MRI response. Overall, 70 % achieved a pre-surgical objective response. Pathological complete response was seen in 3/84 patients. Postmenopausal status (p = 0.005) and invasive lobular carcinoma (p = 0.02) predicted Ki67-based response to NET.

Conclusion

Sequential NET with palbociclib, limiting NAC to non-responders, is a feasible strategy for ER/PGR>50 %, HER2-, TP53 wild-type breast cancers.

背景：虽然新辅助内分泌治疗（NET），有或没有CDK4/6抑制剂，是雌激素受体阳性乳腺癌的既定治疗选择，但最佳患者选择和无反应的二线治疗仍不确定。方法：在开放标签的2期PETREMAC试验（NCT02624973）中，绝经前和绝经后大T2 （>4 cm）或局部晚期ER/PGR> 50%， HER2-和TP53野生型乳腺癌患者接受NET（绝经前患者使用他莫昔芬+戈瑟林，绝经后患者使用来曲唑）。14天后，如果Ki67减少≤50%，则加入帕博西尼。如果NET±帕博西尼未能充分降低Ki67或24周后MRI无客观反应，则引入新辅助化疗（NAC）。对肿瘤活检进行360个癌症相关基因的靶向测序和随后的基因表达谱分析。结果：88例患者中位肿瘤大小为48 mm（范围16 ~ 140 mm）。在49/88（56%）可评估的肿瘤中，单纯NET可减少50%的ki67>。在单纯新辅助内分泌治疗无法抑制Ki67的24/34（71%）肿瘤中，加入palbociclib可使Ki67降低50%，在总共72/88（82%）患者中，Ki67降低50%。由于Ki67反应不足或缺乏MRI反应，34/88（39%）患者接受NAC治疗。总体而言，70%的患者达到了术前客观反应。病理完全缓解3/84例。绝经后状态（p = 0.005）和浸润性小叶癌（p = 0.02）预测基于ki67的NET反应。结论：帕博西尼的序贯NET，将NAC限制在无反应者，是治疗ER/PGR> 50%, HER2-， TP53野生型乳腺癌的可行策略。

{"title":"Neoadjuvant endocrine therapy with sequential palbociclib and chemotherapy based on Ki67 status in stage II-III breast cancer: An open-label, phase II study","authors":"Christina Engebrethsen , Synnøve Yndestad , Mari E. Rasmussen , Emiel A.M. Janssen , Bjørnar Gilje , Egil S. Blix , Helge Espelid , Steinar Lundgren , Jürgen Geisler , Laura Minsaas , Reidun Lillestøl , Hildegunn S. Aase , Turid Aas , Per E. Lønning , Hans P. Eikesdal , Stian Knappskog","doi":"10.1016/j.breast.2025.104672","DOIUrl":"10.1016/j.breast.2025.104672","url":null,"abstract":"<div><h3>Background</h3><div>While neoadjuvant endocrine therapy (NET), with or without a CDK4/6 inhibitor, is an established treatment option for estrogen receptor-positive breast cancers, optimal patient selection and second-line treatment for non-responders remain uncertain.</div></div><div><h3>Methods</h3><div>In the open-label, phase 2 PETREMAC trial (NCT02624973), pre- and postmenopausal patients with large T2 (>4 cm) or locally advanced ER/PGR>50 %, HER2-, and <em>TP53</em> wild-type breast cancers received NET (tamoxifen + goserelin for premenopausal and letrozole for postmenopausal patients). Palbociclib was added if the Ki67 reduction was ≤50 % after 14 days. Neoadjuvant chemotherapy (NAC) was introduced if NET ± palbociclib failed to reduce Ki67 sufficiently or if there was no objective response on MRI after 24 weeks. Tumor biopsies underwent targeted sequencing of 360 cancer-related genes and subsequent gene expression profiling.</div></div><div><h3>Results</h3><div>Among 88 patients, the median tumor size was 48 mm (range 16–140 mm). NET alone reduced Ki67 > 50 % in 49/88 (56 %) of evaluable tumors. Adding palbociclib yielded a Ki67 reduction >50 % in 24/34 (71 %) of tumors where neoadjuvant endocrine therapy alone failed to suppress Ki67, providing a Ki67 reduction of >50 % in a total of 72/88 (82 %) of patients. NAC was administered to 34/88 (39 %) due to inadequate Ki67 response or lack of MRI response. Overall, 70 % achieved a pre-surgical objective response. Pathological complete response was seen in 3/84 patients. Postmenopausal status (p = 0.005) and invasive lobular carcinoma (p = 0.02) predicted Ki67-based response to NET.</div></div><div><h3>Conclusion</h3><div>Sequential NET with palbociclib, limiting NAC to non-responders, is a feasible strategy for ER/PGR>50 %, HER2-, <em>TP53</em> wild-type breast cancers.</div></div>","PeriodicalId":9093,"journal":{"name":"Breast","volume":"85 ","pages":"Article 104672"},"PeriodicalIF":7.9,"publicationDate":"2025-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145910477","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}

引用次数: 0

Trends in local, regional and contralateral breast tumor recurrence within five years after diagnosis in the Netherlands: a population-based study including 121347 patients 荷兰诊断后5年内局部、区域和对侧乳腺肿瘤复发趋势：一项包括121347例患者的基于人群的研究

IF 7.9 2区医学 Q1 OBSTETRICS & GYNECOLOGY

Breast

Pub Date : 2025-12-09 DOI: 10.1016/j.breast.2025.104673

J. Meijer , H.J.G.D. van den Bongard , L.B. Koppert , C.W. Menke-van der Houven van Oordt , L. de Munck , T.J.A. van Nijnatten , M.J.C. van der Sangen , R.J. Schipper , M.K. Schmidt , M.L. Smidt , W. Vreuls , M.C. van Maaren , S. Siesling

Background

The objective was to provide an overview of trends in five-year local recurrence (LR), regional recurrence (RR) and contralateral breast cancer (CBC) rates in the Netherlands from 2003 to 2008 and 2012–2016.

Methods

Women ≥18 years diagnosed with primary early breast cancer between 2003-2008 and 2012–2016 in the Netherlands were included. LR was defined as invasive tumor on the same side as the primary breast cancer. RR was defined as regional lymph node metastasis. CBC was defined as second primary invasive breast tumor in the contralateral breast. Five-year LR, RR and CBC rates were calculated and stratified for age, stage, subtype, and grade.

Results

Of the 121347 included patients, 5618 were diagnosed with a LR, RR or CBC. Five-year LR, RR and CBC rates decreased from 3.3 %, 1.9 % and 2.2 % in 2003 to 1.5 %, 1.6 % and 1.5 % in 2016, respectively, with fluctuations over the years. Slight increases were observed in RR rates for stage II-III, HR-/HER2+ and HR-/HER2-.

Conclusion

(s). The observed overall decline in LR, RR and CBC rates could reflect more effective and personalized breast cancer treatment. Our results provide realistic insights in LR, RR and CBC rates and might contribute to further optimization of treatment and surveillance strategies.

目的是概述2003 - 2008年和2012-2016年荷兰5年局部复发率（LR）、区域复发率（RR）和对侧乳腺癌（CBC）率的趋势。方法纳入2003-2008年至2012-2016年期间荷兰诊断为原发性早期乳腺癌的≥18岁女性。LR被定义为与原发性乳腺癌同侧的浸润性肿瘤。RR定义为区域淋巴结转移。CBC被定义为对侧乳腺第二原发浸润性肿瘤。计算5年的LR、RR和CBC率，并按年龄、分期、亚型和分级进行分层。在121347例纳入的患者中，5618例被诊断为LR、RR或CBC。5年最低工资率、最低工资率和最低工资率分别从2003年的3.3%、1.9%和2.2%降至2016年的1.5%、1.6%和1.5%，历年有所波动。II-III期、HR-/HER2+和HR-/HER2-的RR率略有升高。结论(s)。观察到的LR、RR和CBC率的总体下降可能反映出更有效和个性化的乳腺癌治疗。我们的研究结果提供了LR、RR和CBC率的现实见解，并可能有助于进一步优化治疗和监测策略。

{"title":"Trends in local, regional and contralateral breast tumor recurrence within five years after diagnosis in the Netherlands: a population-based study including 121347 patients","authors":"J. Meijer , H.J.G.D. van den Bongard , L.B. Koppert , C.W. Menke-van der Houven van Oordt , L. de Munck , T.J.A. van Nijnatten , M.J.C. van der Sangen , R.J. Schipper , M.K. Schmidt , M.L. Smidt , W. Vreuls , M.C. van Maaren , S. Siesling","doi":"10.1016/j.breast.2025.104673","DOIUrl":"10.1016/j.breast.2025.104673","url":null,"abstract":"<div><h3>Background</h3><div>The objective was to provide an overview of trends in five-year local recurrence (LR), regional recurrence (RR) and contralateral breast cancer (CBC) rates in the Netherlands from 2003 to 2008 and 2012–2016.</div></div><div><h3>Methods</h3><div>Women ≥18 years diagnosed with primary early breast cancer between 2003-2008 and 2012–2016 in the Netherlands were included. LR was defined as invasive tumor on the same side as the primary breast cancer. RR was defined as regional lymph node metastasis. CBC was defined as second primary invasive breast tumor in the contralateral breast. Five-year LR, RR and CBC rates were calculated and stratified for age, stage, subtype, and grade.</div></div><div><h3>Results</h3><div>Of the 121347 included patients, 5618 were diagnosed with a LR, RR or CBC. Five-year LR, RR and CBC rates decreased from 3.3 %, 1.9 % and 2.2 % in 2003 to 1.5 %, 1.6 % and 1.5 % in 2016, respectively, with fluctuations over the years. Slight increases were observed in RR rates for stage II-III, HR-/HER2+ and HR-/HER2-.</div></div><div><h3>Conclusion</h3><div>(s). The observed overall decline in LR, RR and CBC rates could reflect more effective and personalized breast cancer treatment. Our results provide realistic insights in LR, RR and CBC rates and might contribute to further optimization of treatment and surveillance strategies.</div></div>","PeriodicalId":9093,"journal":{"name":"Breast","volume":"85 ","pages":"Article 104673"},"PeriodicalIF":7.9,"publicationDate":"2025-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145733460","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}

引用次数: 0

Secondary dry eye disease in breast cancer patients: a pilot study 乳腺癌患者继发性干眼病：一项初步研究

IF 7.9 2区医学 Q1 OBSTETRICS & GYNECOLOGY

Breast

Pub Date : 2025-12-08 DOI: 10.1016/j.breast.2025.104677

Antonella Grasso , Andrea Salerno , Alessandra Micera , Alessandro Ferraro , Emilio Fornaro , Graziana Esposito , Marco Coassin , Vittorio Altomare , Antonio Di Zazzo

Purpose

To investigate ocular surface alterations associated with oncological therapy in patients with hormone receptor-positive (HR+) breast cancer.

Methods

In this prospective pilot study, 30 HR + breast cancer patients and 10 age-matched healthy controls were evaluated at three time points: before surgery (T0), one week after surgery before starting therapy (T1), and after 12 months of antiestrogenic treatment (T2). Clinical assessments included Ocular Surface Disease Index (OSDI), Visual Function Questionnaire-25 (VFQ-25), Schirmer test type I, tear break-up time (TBUT), Meibomian gland dysfunction (MGD) score, and corneal and conjunctival staining. Gene expression of IL-6 and ICAM-1 was analyzed via impression cytology.

Results

No differences were observed between cancer patients and controls at baseline. After surgery (T1), patients reported increased OSDI scores (p < 0.05), reduced TBUT (p < 0.01), and worse MGD scores (p < 0.01). After 12 months of treatment (T2), MGD scores, Schirmer test values, and ocular staining worsened significantly (p < 0.01), along with a decline in VFQ-25 scores (p < 0.05). IL-6 and ICAM-1 expression were significantly upregulated at T2. Postmenopausal women experienced more severe ocular surface dysfunction than premenopausal patients.

Conclusions

Antiestrogen therapy in HR + breast cancer patients induces progressive ocular surface dysfunction, driven by chronic inflammation and epithelial damage. These findings highlight the importance of recognizing ocular symptoms in this population and support further studies evaluating the role of routine ophthalmologic monitoring in survivorship care.

目的探讨激素受体阳性（HR+）乳腺癌患者的眼表改变与肿瘤治疗的关系。方法在这项前瞻性先导研究中，30例HR +乳腺癌患者和10例年龄匹配的健康对照者在三个时间点进行评估：术前（T0）、术后开始治疗前一周（T1）和抗雌激素治疗后12个月（T2）。临床评估包括眼表疾病指数（OSDI）、视功能问卷-25 （VFQ-25）、Schirmer试验ⅰ型、泪液破裂时间（TBUT）、睑板腺功能障碍（MGD）评分、角膜及结膜染色。印迹细胞学分析IL-6和ICAM-1基因表达。结果肿瘤患者与对照组在基线时无差异。术后（T1）患者OSDI评分升高（p < 0.05）， TBUT评分降低（p < 0.01）， MGD评分变差（p < 0.01）。治疗12个月（T2）后，MGD评分、Schirmer试验值、眼部染色明显恶化（p < 0.01）， VFQ-25评分下降（p < 0.05）。IL-6和ICAM-1的表达在T2时显著上调。绝经后的妇女比绝经前的患者有更严重的眼表功能障碍。结论雌激素治疗HR +乳腺癌患者可引起慢性炎症和上皮损伤驱动的进行性眼表功能障碍。这些发现强调了在这一人群中识别眼部症状的重要性，并支持进一步研究评估常规眼科监测在生存护理中的作用。

{"title":"Secondary dry eye disease in breast cancer patients: a pilot study","authors":"Antonella Grasso , Andrea Salerno , Alessandra Micera , Alessandro Ferraro , Emilio Fornaro , Graziana Esposito , Marco Coassin , Vittorio Altomare , Antonio Di Zazzo","doi":"10.1016/j.breast.2025.104677","DOIUrl":"10.1016/j.breast.2025.104677","url":null,"abstract":"<div><h3>Purpose</h3><div>To investigate ocular surface alterations associated with oncological therapy in patients with hormone receptor-positive (HR+) breast cancer.</div></div><div><h3>Methods</h3><div>In this prospective pilot study, 30 HR + breast cancer patients and 10 age-matched healthy controls were evaluated at three time points: before surgery (T0), one week after surgery before starting therapy (T1), and after 12 months of antiestrogenic treatment (T2). Clinical assessments included Ocular Surface Disease Index (OSDI), Visual Function Questionnaire-25 (VFQ-25), Schirmer test type I, tear break-up time (TBUT), Meibomian gland dysfunction (MGD) score, and corneal and conjunctival staining. Gene expression of IL-6 and ICAM-1 was analyzed via impression cytology.</div></div><div><h3>Results</h3><div>No differences were observed between cancer patients and controls at baseline. After surgery (T1), patients reported increased OSDI scores (<em>p</em> < 0.05), reduced TBUT (<em>p</em> < 0.01), and worse MGD scores (p < 0.01). After 12 months of treatment (T2), MGD scores, Schirmer test values, and ocular staining worsened significantly (<em>p</em> < 0.01), along with a decline in VFQ-25 scores (<em>p</em> < 0.05). IL-6 and ICAM-1 expression were significantly upregulated at T2. Postmenopausal women experienced more severe ocular surface dysfunction than premenopausal patients.</div></div><div><h3>Conclusions</h3><div>Antiestrogen therapy in HR + breast cancer patients induces progressive ocular surface dysfunction, driven by chronic inflammation and epithelial damage. These findings highlight the importance of recognizing ocular symptoms in this population and support further studies evaluating the role of routine ophthalmologic monitoring in survivorship care.</div></div>","PeriodicalId":9093,"journal":{"name":"Breast","volume":"85 ","pages":"Article 104677"},"PeriodicalIF":7.9,"publicationDate":"2025-12-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145733461","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}

引用次数: 0

Validation of a deep learning-based AI model for breast cancer risk stratification in postmenopausal ER+/HER2-breast cancer patients 基于深度学习的人工智能模型在绝经后ER+/ her2乳腺癌患者中的乳腺癌风险分层验证

IF 7.9 2区医学 Q1 OBSTETRICS & GYNECOLOGY

Breast

Pub Date : 2025-12-04 DOI: 10.1016/j.breast.2025.104671

Sandra Sinius Pouplier , Abhinav Sharma , Pekka Ruusuvuori , Johan Hartman , Maj-Britt Jensen , Bent Ejlertsen , Mattias Rantalainen , Anne-Vibeke Lænkholm

Background

Breast cancer prognostication is crucial for treatment decisions, and the Nottingham Histologic Grade (NHG) system is widely used. However, NHG suffers from interobserver variability, and its division into three risk groups leaves the intermediate group (comprising ∼50 % of patients) overrepresented, making individualized treatment planning challenging as prognosis within this group differ widely.

Objectives

This study aimed to validate the prognostic value of Stratipath's low and high-risk categories and five risk groups and compare NHG performance with the Stratipath deep-learning-based model.

Methods

We analyzed clinical data from 2466 postmenopausal, ER+/HER2-breast cancer patients who did not receive chemotherapy according to guidelines at that time. The NHG and Stratipath models were compared using concordance index and hazard ratios (HR) for distant recurrence (DR), with time to any recurrence (TR) and overall survival (OS) as secondary endpoints.

Results

The Stratipath five-risk group model showed similar performance to the NHG-system in predicting DR (c-index 0.71 vs. 0.72). HR for DR for Stratipath risk groups 2, 3, 4, and 5 were 1.91 (95 % CI: 1.17–3.13), 2.63 (95 % CI: 1.63–4.24), 3.18 (95 % CI: 2.00–5.07), and 3.25 (95 % CI: 2.00–5.28), respectively (p < 0.0001). In the NHG 2 subgroup, Stratipath Breast retained prognostic value for DR (HR for groups 3–5 vs. group 1: 1.73–1.85; p = 0.05), with a c-index of 0.71.

Conclusions

The Stratipath AI model performs similarly to the NHG system. Further prospective validation of the clinical benefits of differentiating Stratipath risk groups 2 and 3 in treatment strategies would be valuable.

乳腺癌预后对治疗决策至关重要，诺丁汉组织学分级（NHG）系统被广泛使用。然而，NHG存在观察者间的可变性，并且将其划分为三个风险组使得中间组（约占患者的50%）被过度代表，这使得个性化治疗计划具有挑战性，因为该组的预后差异很大。目的本研究旨在验证Stratipath的低、高风险类别和五个风险组的预后价值，并比较NHG与Stratipath深度学习模型的性能。方法分析2466例绝经后未按指南接受化疗的ER+/ her2乳腺癌患者的临床资料。采用远端复发（DR）的一致性指数和风险比（HR）对NHG和Stratipath模型进行比较，并以距离任何复发的时间（TR）和总生存期（OS）作为次要终点。结果Stratipath五风险组模型与nhg系统在预测DR方面表现相似（c-index 0.71 vs. 0.72）。分层危险组2、3、4和5的DR HR分别为1.91 （95% CI: 1.17-3.13）、2.63 （95% CI: 1.63-4.24）、3.18 （95% CI: 2.00-5.07）和3.25 (95% CI: 2.00-5.28) （p < 0.0001）。在NHG 2亚组中，分层乳腺保留了DR的预后价值（3-5组相对于1组的HR: 1.73-1.85; p = 0.05）， c指数为0.71。结论Stratipath AI模型的性能与NHG系统相似。进一步的前瞻性验证在治疗策略中区分第2和第3层风险组的临床益处将是有价值的。

{"title":"Validation of a deep learning-based AI model for breast cancer risk stratification in postmenopausal ER+/HER2-breast cancer patients","authors":"Sandra Sinius Pouplier , Abhinav Sharma , Pekka Ruusuvuori , Johan Hartman , Maj-Britt Jensen , Bent Ejlertsen , Mattias Rantalainen , Anne-Vibeke Lænkholm","doi":"10.1016/j.breast.2025.104671","DOIUrl":"10.1016/j.breast.2025.104671","url":null,"abstract":"<div><h3>Background</h3><div>Breast cancer prognostication is crucial for treatment decisions, and the Nottingham Histologic Grade (NHG) system is widely used. However, NHG suffers from interobserver variability, and its division into three risk groups leaves the intermediate group (comprising ∼50 % of patients) overrepresented, making individualized treatment planning challenging as prognosis within this group differ widely.</div></div><div><h3>Objectives</h3><div>This study aimed to validate the prognostic value of Stratipath's low and high-risk categories and five risk groups and compare NHG performance with the Stratipath deep-learning-based model.</div></div><div><h3>Methods</h3><div>We analyzed clinical data from 2466 postmenopausal, ER+/HER2-breast cancer patients who did not receive chemotherapy according to guidelines at that time. The NHG and Stratipath models were compared using concordance index and hazard ratios (HR) for distant recurrence (DR), with time to any recurrence (TR) and overall survival (OS) as secondary endpoints.</div></div><div><h3>Results</h3><div>The Stratipath five-risk group model showed similar performance to the NHG-system in predicting DR (c-index 0.71 vs. 0.72). HR for DR for Stratipath risk groups 2, 3, 4, and 5 were 1.91 (95 % CI: 1.17–3.13), 2.63 (95 % CI: 1.63–4.24), 3.18 (95 % CI: 2.00–5.07), and 3.25 (95 % CI: 2.00–5.28), respectively (p < 0.0001). In the NHG 2 subgroup, Stratipath Breast retained prognostic value for DR (HR for groups 3–5 vs. group 1: 1.73–1.85; p = 0.05), with a c-index of 0.71.</div></div><div><h3>Conclusions</h3><div>The Stratipath AI model performs similarly to the NHG system. Further prospective validation of the clinical benefits of differentiating Stratipath risk groups 2 and 3 in treatment strategies would be valuable.</div></div>","PeriodicalId":9093,"journal":{"name":"Breast","volume":"85 ","pages":"Article 104671"},"PeriodicalIF":7.9,"publicationDate":"2025-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145733462","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}

引用次数: 0

Nodal response to neoadjuvant therapy predicts prognosis of breast cancer patients with clinically positive internal mammary nodes 淋巴结对新辅助治疗的反应预测临床阳性乳腺癌内乳淋巴结患者的预后

IF 7.9 2区医学 Q1 OBSTETRICS & GYNECOLOGY

Breast

Pub Date : 2025-12-03 DOI: 10.1016/j.breast.2025.104670

Zhe Xu , Lu Cao , Wei-Xiang Qi , Gang Cai , Dan Ou , Cheng Xu , Rong Cai , Shu-Yan Li , Jia-Yi Chen

Purpose

To evaluate survival outcomes and prognostic factors in breast cancer patients with clinically positive internal mammary lymph nodes (cIMN+) after combined-modality therapy, and to identify indicators for internal mammary nodal boost irradiation.

Method

Consecutive cIMN + patients between January 2010 and April 2023 were retrospectively reviewed. According to nodal response to neoadjuvant therapy (NAT), patients were divided into three groups: no IMN clinical complete response (cCR) (Group A), IMN cCR without ALN pathological complete response (pCR) (Group B), both IMN cCR and ALN pCR (Group C).

Results

Among 141 eligible patients (median follow-up 49.5 months), the 5-year rates for overall survival (OS) and recurrence-free survival (RFS) were 85.7 % and 76.7 %, respectively. Multivariable analysis confirmed ALN pCR and IMN cCR as independent favorable prognostic factors. Patients in group C exhibited superior 5-year OS (97.4 % vs. 88.9 % vs. 71.0 %, p = 0.007) and RFS (93.9 % vs. 71.8 % vs. 61.4 %, p < 0.001), along with the lowest rate of distant metastasis (5.8 % vs. 22.7 % vs. 33.3 %, p = 0.003) compared to Groups B and A. In Group A patients, higher cumulative radiation dose (≥60 Gy) to IMN significantly improved both 5-year OS (71.0 % vs. 93.5 %, p = 0.009) and 5-year RFS (33.3 % vs. 69.3 %, p = 0.031).

Conclusion

The dual achievement of IMN cCR and ALN pCR after NAT predicts exceptional outcomes. For patients with persistent IMN involvement after NAT, IMN dose escalation to ≥60 Gy significantly improved OS and RFS. These findings support individualized radiotherapy strategies based on nodal response.

目的评价临床内乳淋巴结（cIMN+）阳性乳腺癌患者在综合治疗后的生存结局和预后因素，并确定内乳淋巴结增强放疗的指标。方法回顾性分析2010年1月至2023年4月连续cIMN +患者。根据对新辅助治疗（NAT）的淋巴结反应，将患者分为无IMN临床完全缓解（cCR）组（A组）、无ALN病理完全缓解（pCR）的IMN cCR组（B组）、既有IMN cCR又有ALN pCR的组（C组）。结果141例符合条件的患者（中位随访49.5个月），5年总生存率（OS）为85.7%，无复发生存率（RFS）为76.7%。多变量分析证实ALN pCR和IMN cCR是独立的有利预后因素。C组患者表现出优越的5年OS (97.4% vs 88.9%比71.0%,p = 0.007)和RFS(93.9%比71.8%比61.4%,p & lt; 0.001),以及远处转移率最低(5.8% vs . 22.7%比33.3%,p = 0.003)相比,B组,A组患者中,高累积辐射剂量(≥60 Gy) IMN显著提高两个5年的操作系统(71.0%比93.5%,p = 0.009)和5年RFS(33.3%比69.3%,p = 0.031)。结论NAT后IMN cCR和ALN pCR的双重结果预示着特殊的预后。对于NAT后持续IMN介入的患者，IMN剂量增加到≥60 Gy可显著改善OS和RFS。这些发现支持基于淋巴结反应的个体化放疗策略。

{"title":"Nodal response to neoadjuvant therapy predicts prognosis of breast cancer patients with clinically positive internal mammary nodes","authors":"Zhe Xu , Lu Cao , Wei-Xiang Qi , Gang Cai , Dan Ou , Cheng Xu , Rong Cai , Shu-Yan Li , Jia-Yi Chen","doi":"10.1016/j.breast.2025.104670","DOIUrl":"10.1016/j.breast.2025.104670","url":null,"abstract":"<div><h3>Purpose</h3><div>To evaluate survival outcomes and prognostic factors in breast cancer patients with clinically positive internal mammary lymph nodes (cIMN+) after combined-modality therapy, and to identify indicators for internal mammary nodal boost irradiation.</div></div><div><h3>Method</h3><div>Consecutive cIMN + patients between January 2010 and April 2023 were retrospectively reviewed. According to nodal response to neoadjuvant therapy (NAT), patients were divided into three groups: no IMN clinical complete response (cCR) (Group A), IMN cCR without ALN pathological complete response (pCR) (Group B), both IMN cCR and ALN pCR (Group C).</div></div><div><h3>Results</h3><div>Among 141 eligible patients (median follow-up 49.5 months), the 5-year rates for overall survival (OS) and recurrence-free survival (RFS) were 85.7 % and 76.7 %, respectively. Multivariable analysis confirmed ALN pCR and IMN cCR as independent favorable prognostic factors. Patients in group C exhibited superior 5-year OS (97.4 % vs. 88.9 % vs. 71.0 %, p = 0.007) and RFS (93.9 % vs. 71.8 % vs. 61.4 %, p < 0.001), along with the lowest rate of distant metastasis (5.8 % vs. 22.7 % vs. 33.3 %, p = 0.003) compared to Groups B and A. In Group A patients, higher cumulative radiation dose (≥60 Gy) to IMN significantly improved both 5-year OS (71.0 % vs. 93.5 %, p = 0.009) and 5-year RFS (33.3 % vs. 69.3 %, p = 0.031).</div></div><div><h3>Conclusion</h3><div>The dual achievement of IMN cCR and ALN pCR after NAT predicts exceptional outcomes. For patients with persistent IMN involvement after NAT, IMN dose escalation to ≥60 Gy significantly improved OS and RFS. These findings support individualized radiotherapy strategies based on nodal response.</div></div>","PeriodicalId":9093,"journal":{"name":"Breast","volume":"85 ","pages":"Article 104670"},"PeriodicalIF":7.9,"publicationDate":"2025-12-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145681868","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}

引用次数: 0

Brain imaging screening in metastatic breast cancer: Is it time to rethink clinical guidelines and practice? 转移性乳腺癌的脑成像筛查：是时候重新思考临床指南和实践了吗？

IF 7.9 2区医学 Q1 OBSTETRICS & GYNECOLOGY

Breast

Pub Date : 2025-12-01 DOI: 10.1016/j.breast.2025.104616

Sarah Sammons , Nayan Lamba , Nancy U. Lin

引用次数: 0

Improving communication between healthcare professionals and patients living with advanced breast cancer: a global expert review and call-to-action for 2025–2035 (Goal 5) 改善医疗保健专业人员与晚期乳腺癌患者之间的沟通：全球专家审查和2025-2035年行动呼吁（目标5）

IF 7.9 2区医学 Q1 OBSTETRICS & GYNECOLOGY

Breast

Pub Date : 2025-12-01 DOI: 10.1016/j.breast.2025.104610

Lesley Fallowfield , Fran Boyle , Renate Haidinger , Kara Magsanoc-Alikpala , Luzia Travado , Matti Aapro , Zsofia Wolkensdorfer , Alexandra Lewis , Georgia Attfield , Fatima Cardoso

The complexity of advanced breast cancer (ABC) and its treatment landscape makes communication between healthcare professionals (HCPs) and patients particularly challenging. It is essential that all HCPs receive comprehensive communication skills training starting at medical or nursing school and continuing throughout their careers. Effective communication can improve trust, treatment adherence, and ultimately, outcomes; it also facilitates shared and educated decision-making, all of which is crucial to ensure patients receive the most appropriate treatment and care.

This manuscript explores the global landscape of communication skills training, highlights remaining communication gaps, and assesses the preference for, and implementation of, shared decision-making in clinical practice. It draws on research conducted for the ABC Global Alliance's Global Decade Report 2.0. The main findings are: a) Communication skills trainings now cover a broader range of topics; b) People with ABC report their broader communication needs are often not met; c) Doctors and patients differ in their preferences for shared decision-making in ABC; d) Improving ABC care requires patients to feel supported in expressing their needs.

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.

晚期乳腺癌（ABC）及其治疗前景的复杂性使得医疗保健专业人员（HCPs）与患者之间的沟通尤其具有挑战性。从医学或护理学校开始，所有医护人员都必须接受全面的沟通技巧培训，并在整个职业生涯中持续进行。有效的沟通可以改善信任、治疗依从性，并最终改善结果；它还促进了共同和明智的决策，所有这些对于确保患者获得最适当的治疗和护理至关重要。本文探讨了沟通技巧培训的全球格局，突出了剩余的沟通差距，并评估了临床实践中共同决策的偏好和实施。它借鉴了ABC全球联盟全球十年报告2.0所做的研究。主要发现有：a)沟通技巧培训现在涵盖了更广泛的主题；b)拥有ABC的人报告说，他们更广泛的沟通需求往往得不到满足；c)医生和患者对ABC共同决策的偏好存在差异；d)改善ABC护理需要患者在表达需求时感到得到支持。ABC全球联盟全球十年报告2.0的调查结果为新的ABC全球宪章的制定提供了信息。《ABC全球宪章2.0》为2025-2035年制定了10个新的可实现和可衡量的目标，旨在改善全球ABC患者的生活。

{"title":"Improving communication between healthcare professionals and patients living with advanced breast cancer: a global expert review and call-to-action for 2025–2035 (Goal 5)","authors":"Lesley Fallowfield , Fran Boyle , Renate Haidinger , Kara Magsanoc-Alikpala , Luzia Travado , Matti Aapro , Zsofia Wolkensdorfer , Alexandra Lewis , Georgia Attfield , Fatima Cardoso","doi":"10.1016/j.breast.2025.104610","DOIUrl":"10.1016/j.breast.2025.104610","url":null,"abstract":"<div><div>The complexity of advanced breast cancer (ABC) and its treatment landscape makes communication between healthcare professionals (HCPs) and patients particularly challenging. It is essential that all HCPs receive comprehensive communication skills training starting at medical or nursing school and continuing throughout their careers. Effective communication can improve trust, treatment adherence, and ultimately, outcomes; it also facilitates shared and educated decision-making, all of which is crucial to ensure patients receive the most appropriate treatment and care.</div><div>This manuscript explores the global landscape of communication skills training, highlights remaining communication gaps, and assesses the preference for, and implementation of, shared decision-making in clinical practice. It draws on research conducted for the ABC Global Alliance's Global Decade Report 2.0. The main findings are: a) Communication skills trainings now cover a broader range of topics; b) People with ABC report their broader communication needs are often not met; c) Doctors and patients differ in their preferences for shared decision-making in ABC; d) Improving ABC care requires patients to feel supported in expressing their needs.</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 104610"},"PeriodicalIF":7.9,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145620738","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}

引用次数: 0

Reducing stigma, isolation, and misconceptions in advanced breast cancer: a global expert review and call-to-action for 2025–2035 (Goal 8) 减少对晚期乳腺癌的污名化、孤立和误解：全球专家审查和2025-2035年行动呼吁（目标8）

IF 7.9 2区医学 Q1 OBSTETRICS & GYNECOLOGY

Breast

Pub Date : 2025-12-01 DOI: 10.1016/j.breast.2025.104602

Ranjit Kaur , Rania A. Azmi , Sarah Kutika Nyagabona , Eva Schumacher-Wulf , Stacy Lewis , Daniel Egbase , Alexandra Lewis , Georgia Attfield , Fatima Cardoso

Despite significant advances in the diagnosis and treatment of advanced breast cancer (ABC), people living with the disease continue to experience profound social isolation on a global scale. The multifaceted physical, financial, and emotional challenges inherent to ABC are frequently misunderstood or underestimated, resulting in persistent stigma, social exclusion, and an elevated risk of adverse mental health outcomes for affected individuals. Misconceptions regarding ABC among healthcare professionals (HCPs) or the public exacerbate these challenges and further compound the overall disease burden.

This manuscript examines how stigma, social isolation, and misconceptions surrounding ABC have evolved globally since 2015. It summarizes research conducted for the ABC Global Alliance's Global Decade Report 2.0. The main findings are: a) Online mentions of ABC are increasing, but remain lower than general breast cancer; b) Despite progress, social and workplace stigma still impacts people with ABC; c) Stigma and isolation associated with ABC varies by geography and income level; d) Awareness of ABC has improved, but misconceptions persist.

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.

尽管在晚期乳腺癌的诊断和治疗方面取得了重大进展，但该疾病患者在全球范围内继续遭受严重的社会孤立。ABC固有的多方面的身体、经济和情感挑战经常被误解或低估，导致持续的耻辱，社会排斥，以及受影响个体不良心理健康结果的风险增加。卫生保健专业人员（HCPs）或公众对ABC的误解加剧了这些挑战，并进一步加重了总体疾病负担。本文研究了自2015年以来，围绕ABC的耻辱、社会孤立和误解是如何在全球范围内演变的。它总结了为ABC全球联盟全球十年报告2.0所做的研究。主要发现有：a)网上对ABC的提及有所增加，但仍低于一般乳腺癌；b)尽管取得了进展，但社会和工作场所的耻辱感仍然影响着ABC患者；c)与ABC相关的耻辱和孤立因地理位置和收入水平而异；d)对ABC的认识有所提高，但误解仍然存在。ABC全球联盟全球十年报告2.0的调查结果为新的ABC全球宪章的制定提供了信息。《ABC全球宪章2.0》为2025-2035年制定了10个新的可实现和可衡量的目标，旨在改善全球ABC患者的生活。

{"title":"Reducing stigma, isolation, and misconceptions in advanced breast cancer: a global expert review and call-to-action for 2025–2035 (Goal 8)","authors":"Ranjit Kaur , Rania A. Azmi , Sarah Kutika Nyagabona , Eva Schumacher-Wulf , Stacy Lewis , Daniel Egbase , Alexandra Lewis , Georgia Attfield , Fatima Cardoso","doi":"10.1016/j.breast.2025.104602","DOIUrl":"10.1016/j.breast.2025.104602","url":null,"abstract":"<div><div>Despite significant advances in the diagnosis and treatment of advanced breast cancer (ABC), people living with the disease continue to experience profound social isolation on a global scale. The multifaceted physical, financial, and emotional challenges inherent to ABC are frequently misunderstood or underestimated, resulting in persistent stigma, social exclusion, and an elevated risk of adverse mental health outcomes for affected individuals<strong>.</strong> Misconceptions regarding ABC among healthcare professionals (HCPs) or the public exacerbate these challenges and further compound the overall disease burden<strong>.</strong></div><div>This manuscript examines how stigma, social isolation, and misconceptions surrounding ABC have evolved globally since 2015. It summarizes research conducted for the ABC Global Alliance's Global Decade Report 2.0. The main findings are: a) Online mentions of ABC are increasing, but remain lower than general breast cancer; b) Despite progress, social and workplace stigma still impacts people with ABC; c) Stigma and isolation associated with ABC varies by geography and income level; d) Awareness of ABC has improved, but misconceptions persist.</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 104602"},"PeriodicalIF":7.9,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145620741","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}

引用次数: 0

Improving the quality of life of people with advanced breast cancer: a global expert review and call-to-action for 2025–2035 (goal 3) 改善晚期乳腺癌患者的生活质量：全球专家审查和2025-2035年行动呼吁（目标3）

IF 7.9 2区医学 Q1 OBSTETRICS & GYNECOLOGY

Breast

Pub Date : 2025-12-01 DOI: 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.

晚期乳腺癌（ABC）治疗领域的进展显著延长了该疾病患者的生存期。然而，仅仅长寿是不够的；维持和提高生活质量（QoL）对于确保ABC患者不仅寿命更长，而且生活充实至关重要。文献一致强调了ABC患者未满足的心理社会需求及其对生活质量的负面影响。此外，许多提高认识和支持方案不成比例地侧重于早期乳腺癌，导致对ABC患者的信息、资源以及医疗和心理支持存在巨大差距，这反过来又会加剧孤立感和耻辱感。本文探讨了ABC对生活质量的影响，并借鉴了ABC全球联盟全球十年报告2.0的研究成果。主要发现是：a)在过去十年中，ABC亚型之间的生活质量改善有所不同，三阴性ABC患者的生活质量最低；b) ABC对生活质量的影响在人口之间仍然不平等；c) ABC治疗的低度副反应对生活质量影响深远；d) ABC对照护者生活质量有实质性影响；e)许多生活质量评估工具目前无法捕捉ABC患者的具体需求。ABC全球联盟全球十年报告2.0的调查结果为新的ABC全球宪章的制定提供了信息。《ABC全球宪章2.0》为2025-2035年制定了10个新的可实现和可衡量的目标，旨在改善全球ABC患者的生活。

{"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}

引用次数: 0