Breast最新文献

{"title":"Management and outcomes for older women with early breast cancer treated with primary endocrine therapy (PET)","authors":"Thomas Hubbard ,&nbsp;Georgia Wright ,&nbsp;Jenna Morgan ,&nbsp;Charlene Martin ,&nbsp;Stephen Walters ,&nbsp;Kwok-Leung Cheung ,&nbsp;Riccardo Audisio ,&nbsp;Malcolm Reed ,&nbsp;Lynda Wyld ,&nbsp;the Bridging the Age Gap Trial Management Group","doi":"10.1016/j.breast.2024.103768","DOIUrl":"https://doi.org/10.1016/j.breast.2024.103768","url":null,"abstract":"<div><h3>Background</h3><p>This study reports the detailed management and outcomes of women treated with Primary Endocrine Therapy (PET) in a large prospective UK cohort of older women (≥70) with breast cancer.</p></div><div><h3>Methods</h3><p>This was an unplanned secondary analysis of a prospective, multicentre, observational study (The Age Gap study). Data were collected at baseline and regular intervals on patient, tumour and treatment characteristics with tumour RECIST response category recorded. Direct study follow-up was 24 months with longer-term survival data obtained from the UK cancer registry.</p></div><div><h3>Results</h3><p>The Age Gap study recruited 3316 women across 56 breast units. Primary endocrine therapy (PET) was initiated for 505/3316 (15 %) women; median age was 84 (IQR 79–88) with median follow-up 41.9 months (IQR 27–60). Death occurred in 205/505(40.6 %) patients, 160/205; 78 % non- Breast Cancer related, 45/205; 21.9 % Breast Cancer related. Multivariate analysis identified older age (HR-1.055(95 % Confidence Interval: 1.029–1.084); P &lt; 0.001) and higher Charlson Index (HR-1.166 (1.086–1.252); P &lt; 0.001) as risk factors for all-cause mortality, but conversion to surgery (HR-0.372(0.152–0.914); P = 0.031) was protective. Grade 3 cancer (G1 vs G3 HR-0.28 (0.094–0.829); P = 0.022 &amp; G2 vs G3 HR-0.469 (0.226–0.973); P = 0.042), axillary positivity (axilla positivity HR-2.548 (1.321–4.816); P = 0.005) and change of endocrine therapy (HR-3.010 (1.532–5.913); P = 0.001) were associated with worse breast cancer specific survival (BCSS). RECIST category was not significantly associated with either overall survival or BCSS (P &gt; 0.05).</p></div><div><h3>Conclusion</h3><p>Early disease response and change of endocrine therapy are not significantly associated with overall survival, conversion to surgery is linked to improved outcome. Prognosis is largely determined by age and comorbidity in older women treated with PET.</p></div>","PeriodicalId":9093,"journal":{"name":"Breast","volume":"77 ","pages":"Article 103768"},"PeriodicalIF":5.7,"publicationDate":"2024-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0960977624000997/pdfft?md5=9e6be7b9ebc9fb132beca29e2bebd1ab&pid=1-s2.0-S0960977624000997-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141594808","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}

{"title":"Digital breast tomosynthesis for breast cancer diagnosis in women with dense breasts and additional breast cancer risk factors: A systematic review","authors":"Smriti Raichand ,&nbsp;Vendula Blaya-Novakova ,&nbsp;Slavica Berber ,&nbsp;Ann Livingstone ,&nbsp;Naomi Noguchi ,&nbsp;Nehmat Houssami","doi":"10.1016/j.breast.2024.103767","DOIUrl":"https://doi.org/10.1016/j.breast.2024.103767","url":null,"abstract":"<div><h3>Introduction</h3><p>Digital breast tomosynthesis (DBT) may improve sensitivity in population screening. However, evidence is currently limited on the performance of DBT in patients at a higher risk of breast cancer. This systematic review compares the clinical effectiveness and cost-effectiveness of DBT, digital mammography (DM), and ultrasound, for breast cancer detection in women with dense breasts and additional risk factors.</p></div><div><h3>Methods</h3><p>Medline, Embase, and Evidence-Based Medicine Reviews via OvidSP were searched to identify literature from 2010 to August 21, 2023. Selection of studies, data extraction, and quality assessment (using QUADAS-2 and CHEERS) were completed in duplicate. Findings were summarised descriptively and narratively.</p></div><div><h3>Results</h3><p>Twenty-six studies met pre-specified inclusion criteria. In women with breast symptoms or recalled for investigation of screen-detected findings (19 studies), DBT may be more accurate than DM. For example, in symptomatic women, the sensitivity of DBT + DM ranged from 82.8 % to 92.5 % versus 56.8 %–81.3 % for mammography (DM/synthesised images). However, most studies had a high risk of bias due to participant selection. Evidence regarding DBT in women with a personal or family history of breast cancer, for DBT versus ultrasound alone, and cost-effectiveness of DBT was limited.</p></div><div><h3>Conclusions</h3><p>In women with dense breasts and additional risk factors for breast cancer, evidence is limited about the accuracy of DBT compared to other imaging modalities, particularly in those with personal or family history of breast cancer. Future research in this population should consider head-to-head comparisons of imaging modalities to determine the relative effectiveness of these imaging tests.</p></div><div><h3>Systematic review registration</h3><p>PROSPERO registration number CRD42021236470.</p></div>","PeriodicalId":9093,"journal":{"name":"Breast","volume":"77 ","pages":"Article 103767"},"PeriodicalIF":5.7,"publicationDate":"2024-07-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0960977624000985/pdfft?md5=80d16eef5e28cdec676635413a5f5cef&pid=1-s2.0-S0960977624000985-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141594573","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}

{"title":"Factors influencing 5-year persistence to adjuvant endocrine therapy in young women with breast cancer","authors":"Eleonora Pagan ,&nbsp;Monica Ruggeri ,&nbsp;Nadia Bianco ,&nbsp;Eraldo Oreste Bucci ,&nbsp;Rossella Graffeo ,&nbsp;Markus Borner ,&nbsp;Monica Giordano ,&nbsp;Lorenzo Gianni ,&nbsp;Manuela Rabaglio ,&nbsp;Andrea Freschi ,&nbsp;Elisabetta Cretella ,&nbsp;Elena Seles ,&nbsp;Alberto Farolfi ,&nbsp;Edda Simoncini ,&nbsp;Mariangela Ciccarese ,&nbsp;Daniel Rauch ,&nbsp;Adolfo Favaretto ,&nbsp;Friedemann Honecker ,&nbsp;Rossana Berardi ,&nbsp;Alessandra Franzetti-Pellanda ,&nbsp;Karin Ribi","doi":"10.1016/j.breast.2024.103765","DOIUrl":"10.1016/j.breast.2024.103765","url":null,"abstract":"<div><h3>Purpose</h3><p>Although younger age has been negatively associated with persistence to adjuvant endocrine therapy (ET), factors contributing to non-persistence remain poorly understood. We assessed factors associated with non-persistence to ET and described the 5-year trajectories of quality of life (QoL) and symptoms in young women (≤40 years) with hormone receptor-positive breast cancer (BC).</p></div><div><h3>Methods</h3><p>We retrieved data on clinical characteristics and non-persistence from the medical annual records in the European cohort of the “Helping Ourselves, Helping Others: The Young Women's BC Study” (IBCSG 43-09 HOHO). Women completed surveys at baseline, biannually for three years, and annually for another seven years. Data collection included sociodemographic information, QoL aspects assessed by the Cancer Rehabilitation Evaluation System-Short Form and symptoms assessed by the Breast Cancer Prevention Trial symptom scales. Cox regression models were applied to identify factors associated with non-persistence.</p></div><div><h3>Results</h3><p>The cumulative risk of interrupting ET within 5 years was 27.7 % (95 % CI, 21.5–35.2). The QoL subscale scores remained stable over 5 years, with slight improvements in the physical subscale. Hot flashes decreased (p &lt; 0.001), while vaginal problems intensified (p &lt; 0.001) over time. Being married without children and having difficulties interacting and communicating with the medical team were significantly associated with non-persistence.</p></div><div><h3>Conclusions</h3><p>Discussing the desire to conceive with partnered childless women and establishing a good relationship with the medical team may be important in addressing the non-persistence in young BC survivors. As recent data suggests the safety of pausing ET to conceive, this approach may be a reasonable future option to limit non-persistence.</p></div>","PeriodicalId":9093,"journal":{"name":"Breast","volume":"77 ","pages":"Article 103765"},"PeriodicalIF":5.7,"publicationDate":"2024-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0960977624000961/pdfft?md5=9f1ed1e3e31560f600d157a14cab7dd7&pid=1-s2.0-S0960977624000961-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141603291","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}

{"title":"Questionnaire survey and analysis of drug clinical research implementation capabilities of breast cancer treatment departments in Chinese hospitals","authors":"Bo Lan ,&nbsp;Xuenan Peng ,&nbsp;Fei Ma","doi":"10.1016/j.breast.2024.103766","DOIUrl":"10.1016/j.breast.2024.103766","url":null,"abstract":"<div><h3>Background</h3><p>Clinical research competence determines the quality of clinical research and the reliability of research findings. We aimed to explore the clinical research implementation capabilities of breast cancer treatment departments in China.</p></div><div><h3>Methods</h3><p>This was a department-based cross-sectional study conducted in the form of electronic questionnaires on the Wenjuanxing platform from 7th August to 31^st August 2023 among hospitals from the first batch of breast cancer standardized diagnosis and treatment quality control pilot centers in China.</p></div><div><h3>Results</h3><p>A total of 127 questionnaires from 122 hospitals were ultimately included in the analysis. Medical personnel involved in the clinical research of 118 (92.9 %) departments received good clinical practice (GCP) training. The steps of the approval process from research initiation to completion lasted 2–4 weeks or longer. The majority of departments initiated or participated in 2 or fewer clinical research projects over the past year. Among the differences between different departments, the Department of Medical Oncology had a better qualification profile and process and greater number of initiated and participated clinical studies than did the Department of Surgical Oncology. For needs and problems, most of the departments were strongly willing to undertake clinical research and receive professional training; the most common problem in the process of conducting studies was patient recruitment.</p></div><div><h3>Conclusions</h3><p>Most departments generally exhibited complete capabilities for implementing clinical research. Improvements in implementation efficiency, quality of research and patient recruitment are still needed. Professional training and communication, as well as the recommendation of clinical research, are required in future development.</p></div>","PeriodicalId":9093,"journal":{"name":"Breast","volume":"77 ","pages":"Article 103766"},"PeriodicalIF":5.7,"publicationDate":"2024-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0960977624000973/pdfft?md5=23cd817517c55e5015c5977c97340707&pid=1-s2.0-S0960977624000973-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141544462","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}

{"title":"DCIS knowledge of women choosing between active surveillance and surgery for low-risk DCIS","authors":"E.G. Engelhardt ,&nbsp;R.S.J.M. Schmitz ,&nbsp;M.A. Gerritsma ,&nbsp;C.M.T. Sondermeijer ,&nbsp;E. Verschuur ,&nbsp;J.H.E. Houtzager ,&nbsp;R. Griffioen ,&nbsp;N. Bijker ,&nbsp;R.M. Mann ,&nbsp;V. Retèl ,&nbsp;F.H. van Duijnhoven ,&nbsp;J. Wesseling ,&nbsp;E.M.A. Bleiker","doi":"10.1016/j.breast.2024.103764","DOIUrl":"10.1016/j.breast.2024.103764","url":null,"abstract":"<div><h3>Background</h3><p>Ductal carcinoma in situ (DCIS) can progress to invasive breast cancer (IBC), but often never will. As we cannot predict accurately which DCIS-lesions will or will not progress to IBC, almost all women with DCIS undergo breast-conserving surgery supplemented with radiotherapy, or even mastectomy. In some countries, endocrine treatment is prescribed as well. This implies many women with non-progressive DCIS undergo overtreatment. To reduce this, the LORD patient preference trial (LORD-PPT) tests whether mammographic active surveillance (AS) is safe by giving women with low-risk DCIS a choice between treatment and AS. For this, sufficient knowledge about DCIS is crucial. Therefore, we assessed women's DCIS knowledge in association with socio-demographic and clinical characteristics.</p></div><div><h3>Methods</h3><p>LORD-PPT participants (N = 376) completed a questionnaire assessing socio-demographic and clinical characteristics, risk perception, treatment choice and DCIS knowledge after being informed about their diagnosis and treatment options.</p></div><div><h3>Results</h3><p>66 % of participants had poor knowledge (i.e., answered ≤3 out of 7 knowledge items correctly). Most incorrect answers involved overestimating the safety of AS and misunderstanding of DCIS prognostic risks. Overall, women with higher DCIS knowledge score perceived their risk of developing IBC as being somewhat higher than women with poorer knowledge (p = 0.049). Women with better DCIS knowledge more often chose surgery whilst most women with poorer knowledge chose active surveillance (p = 0.049).</p></div><div><h3>Discussion</h3><p>Our findings show that there is room for improvement of information provision to patients. Decision support tools for patients and clinicians could help to stimulate effective shared decision-making about DCIS management.</p></div>","PeriodicalId":9093,"journal":{"name":"Breast","volume":"77 ","pages":"Article 103764"},"PeriodicalIF":5.7,"publicationDate":"2024-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S096097762400095X/pdfft?md5=73c465742c1edf92fe80254d590dc8ad&pid=1-s2.0-S096097762400095X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141544461","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}

{"title":"Cropsi study: Efficacy and safety of cryotherapy and cryocompression in the prevention of chemotherapy-induced peripheral neuropathy in patients with breast and gynecological cancer–A prospective, randomized trial","authors":"Christine Brunner ,&nbsp;Miriam Emmelheinz ,&nbsp;Daniel Egle,&nbsp;Magdalena Ritter,&nbsp;Katharina Leitner,&nbsp;Verena Wieser,&nbsp;Carmen Albertini,&nbsp;Samira Abdel Azim,&nbsp;Irene Mutz-Dehbalaie,&nbsp;Johanna Kögl,&nbsp;Christian Marth","doi":"10.1016/j.breast.2024.103763","DOIUrl":"10.1016/j.breast.2024.103763","url":null,"abstract":"<div><h3>Objective</h3><p>This study aimed to demonstrate the superiority of cryocompression over cryotherapy alone in the prevention of chemotherapy-induced peripheral neuropathy (CIPN) grade 2 or above.</p></div><div><h3>Methods</h3><p>This prospective randomized study was conducted between May 2020 and January 2023 in Innsbruck. Eligible patients had a diagnosis of gynecological cancer and received a minimum of 3 cycles of taxane-based CT (neoadjuvant, adjuvant or palliative therapy). Patients were randomized 1:1 to receive either cryotherapy or cryocompression on their upper extremities during chemotherapy (CT). We performed temperature measurements, two QoL questionnaires and neurological tests during CT and at follow-up 3 and 6–9 months after the completion of CT. CIPN was assessed using the CTCAE score.</p></div><div><h3>Results</h3><p>Of 200 patients recruited, both groups showed a lower prevalence of CIPN in this study compared to recent literature. In the group receiving cryotherapy, the prevalence of grade 1 CIPN was 30.1 %, and that of grade 2 CIPN or above was 13.7 %; in the group treated with cryocompression, the prevalence of grade 1 CIPN was 32.8 %, and that of grade 2 or above CIPN was 17.2 %. We found a significant reduction in temperature in the cryotherapy and cryocompression groups. Regarding the two QOL questionnaires as well as the neurological tests no significant differences were found between the two groups.</p></div><div><h3>Conclusion</h3><p>Our study suggests that cryotherapy as well as cryocompression is a safe and effective way to cool patients’ extremities to lower the prevalence of CIPN. Cryocompression was not more effective than cryotherapy alone in the prevention of CIPN.</p></div>","PeriodicalId":9093,"journal":{"name":"Breast","volume":"76 ","pages":"Article 103763"},"PeriodicalIF":5.7,"publicationDate":"2024-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0960977624000948/pdfft?md5=b4d45058f69333bd4b6f1b464ed927f6&pid=1-s2.0-S0960977624000948-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141466154","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}

{"title":"The features of male breast cancer in China: A real-world study","authors":"Yuxuan Gao ,&nbsp;Mengmeng Zhang ,&nbsp;Gang Sun ,&nbsp;Li Ma ,&nbsp;Jianyun Nie ,&nbsp;Zhongyu Yuan ,&nbsp;Zhenzhen Liu ,&nbsp;Yali Cao ,&nbsp;Jianbin Li ,&nbsp;Qiang Liu ,&nbsp;Songqing Ye ,&nbsp;Bo Chen ,&nbsp;Yuhua Song ,&nbsp;Kun Wang ,&nbsp;Yu Ren ,&nbsp;Guolin Ye ,&nbsp;Ling Xu ,&nbsp;Shu Liu ,&nbsp;Qianjun Chen ,&nbsp;Weiwen Li ,&nbsp;Ying Lin","doi":"10.1016/j.breast.2024.103762","DOIUrl":"10.1016/j.breast.2024.103762","url":null,"abstract":"<div><h3>Background</h3><p>Male breast cancer (MBC) is a rare disease. Although several large-scale studies have investigated MBC patients in other countries, the features of MBC patients in China have not been fully explored. This study aims to explore the features of Chinese MBC patients comprehensively.</p></div><div><h3>Methods</h3><p>We retrospectively collected data of MBC patients from 36 centers in China. Overall survival (OS) was evaluated by the Kaplan-Meier method, log-rank test, and Cox regression analyses. Multivariate Cox analyses were used to identify independent prognostic factors of the patients.</p></div><div><h3>Results</h3><p>In total, 1119 patients were included. The mean age at diagnosis was 60.9 years, and a significant extension over time was observed (<em>P</em> &lt; 0.001). The majority of the patients (89.1 %) received mastectomy. Sentinel lymph node biopsy was performed in 7.8 % of the patients diagnosed in 2009 or earlier, and this percentage increased significantly to 38.8 % in 2020 or later (<em>P</em> &lt; 0.001). The five-year OS rate for the population was 85.5 % [95 % confidence interval (CI), 82.8 %–88.4 %]. Multivariate Cox analysis identified taxane-based [T-based, hazard ratio (HR) = 0.32, 95 % CI, 0.13 to 0.78, <em>P</em> = 0.012] and anthracycline plus taxane-based (A + T-based, HR = 0.47, 95 % CI, 0.23 to 0.96, <em>P</em> = 0.037) regimens as independent protective factors for OS. However, the anthracycline-based regimen showed no significance in outcome (<em>P</em> = 0.175).</p></div><div><h3>Conclusion</h3><p>As the most extensive MBC study in China, we described the characteristics, treatment and prognosis of Chinese MBC population comprehensively. T-based and A + T-based regimens were protective factors for OS in these patients. More research is required for this population.</p></div>","PeriodicalId":9093,"journal":{"name":"Breast","volume":"76 ","pages":"Article 103762"},"PeriodicalIF":5.7,"publicationDate":"2024-06-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0960977624000936/pdfft?md5=867aad1137306ceac4b3cc06bea34880&pid=1-s2.0-S0960977624000936-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141455294","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}

{"title":"Impact of coadministration of proton-pump inhibitors and palbociclib in hormone receptor-positive/HER2-negative advanced breast cancer","authors":"Serena Di Cosimo ,&nbsp;José Manuel Pérez-García ,&nbsp;Meritxell Bellet ,&nbsp;Florence Dalenc ,&nbsp;Miguel J. Gil Gil ,&nbsp;Manuel Ruiz-Borrego ,&nbsp;Joaquín Gavilá ,&nbsp;Elena Aguirre ,&nbsp;Peter Schmid ,&nbsp;Frederik Marmé ,&nbsp;Joseph Gligorov ,&nbsp;Andreas Schneeweiss ,&nbsp;Joan Albanell ,&nbsp;Pilar Zamora ,&nbsp;Duncan Wheatley ,&nbsp;Eduardo Martínez de Dueñas ,&nbsp;Kepa Amillano ,&nbsp;Eileen Shimizu ,&nbsp;Miguel Sampayo-Cordero ,&nbsp;Javier Cortés ,&nbsp;Antonio Llombart-Cussac","doi":"10.1016/j.breast.2024.103761","DOIUrl":"https://doi.org/10.1016/j.breast.2024.103761","url":null,"abstract":"<div><h3>Background</h3><p>The capsule formulation of CDK4/6 inhibitor palbociclib has reduced solubility at gastric pH &gt; 4.5 and may have decreased activity when used with proton-pump inhibitors (PPI). Herein, we report the effect of PPI on palbociclib capsule activity and safety in the PARSIFAL study.</p></div><div><h3>Methods</h3><p>First-line endocrine-sensitive, hormone receptor-positive (HR+)/human epidermal growth factor receptor 2-negative (HER2-) advanced breast cancer (ABC) patients received palbociclib capsules plus fulvestrant or letrozole. The primary endpoint was progression-free survival (PFS). This post-hoc analysis compared PPI use. Patients were PPI-naïve (N-PPI) if not on PPI during the study, and either early (E-PPI) or long-term PPI (LT-PPI) if on PPI at study entry or for at least ≥⅔ of treatment, respectively. PPI groups were not mutually exclusive.</p></div><div><h3>Results</h3><p>Among 486 patients, 66.9 % were N-PPI, 13.2 % E-PPI, 18.7 % LT-PPI, and 11.5 % of the PPI users were defined as neither. Median PFS (mPFS) was 29.6 months in the study population, 28.7 months in N-PPI, 23.0 months in E-PPI (Hazard Ratio [HR] 1.5; 95%Confidence Interval [CI] 1.1–2.2; p = 0.024), and 23.0 months in LT-PPI (HR 1.4; 95%CI 1.0–1.9; p = 0.035). By landmark analysis, PPI use was associated with poorer mPFS at 3 and 12 months. Grade ≥3 hematological adverse events occurred in 71.7 % of N-PPI, 57.8 % of E-PPI (p = 0.021), and 54.9 % of LT-PPI (p = 0.003). Dose reductions and dosing delays due to hematological toxicity occurred in 70.8 % of N-PPI, 56.3 % of E-PPI (p = 0.018), and 52.7 % of LT-PPI (p = 0.002).</p></div><div><h3>Conclusions</h3><p>PPI use may reduce palbociclib capsule toxicity, dose modifications, and clinical activity in HR+/HER2- ABC.</p></div>","PeriodicalId":9093,"journal":{"name":"Breast","volume":"76 ","pages":"Article 103761"},"PeriodicalIF":3.9,"publicationDate":"2024-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0960977624000924/pdfft?md5=3391c2456e6478a8f91e8201433374e0&pid=1-s2.0-S0960977624000924-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141325219","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}

{"title":"Clinicopathological characteristics and genomic profiling of pure mucinous breast cancer","authors":"Qianyi Lu ,&nbsp;Hanxing Zhou ,&nbsp;Jianwei Zhang ,&nbsp;Kaping Lee ,&nbsp;Limin Chen ,&nbsp;Ruoxi Hong ,&nbsp;Kuikui Jiang ,&nbsp;Fei Xu ,&nbsp;Wen Xia ,&nbsp;Boyang Cao ,&nbsp;Jingmin Zhang ,&nbsp;Kang Shao ,&nbsp;Peng Sun ,&nbsp;Shusen Wang","doi":"10.1016/j.breast.2024.103760","DOIUrl":"https://doi.org/10.1016/j.breast.2024.103760","url":null,"abstract":"<div><h3>Purpose</h3><p>Pure mucinous breast cancer (PMC) is a rare histological type with a favourable prognosis. However, cases with recurrence have been reported and diagnosed in clinical practice. The mechanisms underlying PMC recurrence remain unknown. In this study, we aimed to identify the prognostic factors associated with PMC.</p></div><div><h3>Materials and methods</h3><p>A total of 166 patients diagnosed with PMC were included. We compared the clinicopathological characteristics between patients with and without recurrence. The 21-gene assay was performed in 10 patients with recurrence and 20 TNM stage-matched patients without recurrence. Whole-exon sequencing was performed in 12 PMC primary tumours and four positive lymph nodes (LNs).</p></div><div><h3>Results</h3><p>Tumour size, lymph node status and TNM staging differed significantly between recurrent group and non-recurrent group. And the 21-gene recurrence scores did not differ significantly between recurrent group and its TNM stage-matched non-recurrent group. The most frequently mutated genes in the primary tumours of regional LN-positive PMCs were ADCY10 (3/6) and SHANK3 (3/6), and they more recurrently harboured gains of 15q23, 17q23.2 and 20p11.21, and loss of 21p11.2. And these alterations were not detected in primary tumours of regional LN-negative PMCs.</p></div><div><h3>Conclusion</h3><p>TNM stage is an important prognostic factor in PMC. Although we revealed that regional LN-positive PMCs show increased occurrence of duplication variants at 15q23, 17q23.2 and 20p11.21, and deletion variants at 21p11.2. Further investigation, including multi-omics studies, are needed and may provide additional insights into the nature of PMC.</p></div>","PeriodicalId":9093,"journal":{"name":"Breast","volume":"76 ","pages":"Article 103760"},"PeriodicalIF":3.9,"publicationDate":"2024-06-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0960977624000912/pdfft?md5=1aaf38b213fac76e9f73f440e37cbb0a&pid=1-s2.0-S0960977624000912-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141423971","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}

{"title":"Capturing longer term surgical outcome measures as part of routine care of breast cancer patients","authors":"Astrid E. Leusink ,&nbsp;Amy R. Godden ,&nbsp;Nihal Yildirim ,&nbsp;Antonia Randawa ,&nbsp;Rebekah Law ,&nbsp;Jennifer E. Rusby","doi":"10.1016/j.breast.2024.103758","DOIUrl":"https://doi.org/10.1016/j.breast.2024.103758","url":null,"abstract":"<div><h3>Introduction</h3><p>The transition away from routine clinical follow up after breast cancer towards imaging surveillance and patient-initiated contact limits opportunities for patients and doctors to communicate about the long-term effects of treatment. The ABS oncoplastic guidelines (2021) recommend that post-operative 2D images and patient-reported outcomes (PROMs) are routinely collected but give no guidance as to how best to implement this.</p></div><div><h3>Methods</h3><p>From December 2019 until March 2024, women due for their year 3 or 5 surveillance mammogram at The Royal Marsden Sutton site were invited to complete a BREAST-Q questionnaire and attend medical photography. Panel assessment of photographs was undertaken. Results were presented to the oncoplastic MDT, including summary PROMs and illustrative case presentations. Free-text comments were shared with the relevant teams. Associations between demographic or clinic-pathological factors and uptake were investigated.</p></div><div><h3>Results</h3><p>Of the 1211 women invited, 246 patients (20.3 %) completed BREAST-Q questionnaires, 182 (15.0 %) attended for medical photography and 114 (9.4 %) completed both. Uptake was not associated with age, ethnicity or surgical factors but patients with higher BMI were less likely to respond to the questionnaire. Patients who had undergone complex oncoplastic procedures were more likely to respond than those who had simple procedures. Patient-reported outcome results were in line with the published literature.</p></div><div><h3>Conclusion</h3><p>Reviewing images with their paired PROMs and discussing free-text feedback was instructive for the team. Work is needed to identify barriers to patient participation and improve uptake to be representative of the overall patient population. Quantifying appearance in photographs would help summarise aesthetic outcome data.</p></div>","PeriodicalId":9093,"journal":{"name":"Breast","volume":"76 ","pages":"Article 103758"},"PeriodicalIF":3.9,"publicationDate":"2024-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0960977624000894/pdfft?md5=55405325370c3ad8c79e496ab2237601&pid=1-s2.0-S0960977624000894-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141289925","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}