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Microcalcifications in benign breast biopsies: association with lesion type and risk. 良性乳腺活组织检查中的微钙化:与病变类型和风险的关系。
IF 3 3区 医学 Q2 ONCOLOGY Pub Date : 2024-12-01 Epub Date: 2024-09-04 DOI: 10.1007/s10549-024-07448-x
Sarah Schrup, Heather Hardway, Robert A Vierkant, Stacey J Winham, Matthew R Jensen, Bryan McCauley, Tanya Hoskin, Lisa Seymour, Denice Gehling, Jessica Fischer, Celine M Vachon, Santo Maimone, Laura Pacheco-Spann, Derek C Radisky, Jodi M Carter, Amy C Degnim, Mark E Sherman

Purpose: To characterize associations of microcalcifications (calcs) with benign breast disease lesion subtypes and assess whether tissue calcs affect risks of ductal carcinoma in situ (DCIS) and invasive breast cancer (IBC).

Methods: We analyzed detailed histopathologic data for 4,819 BBD biopsies from a single institution cohort (2002-2013) followed for DCIS or IBC for a median of 7.4 years for cases (N = 338) and 11.2 years for controls. Natural language processing was used to identify biopsies containing calcs based on pathology reports. Univariable and multivariable regression models were applied to assess associations with BBD lesion type and age-adjusted Cox proportional hazard regressions were performed to model risk of IBC or DCIS stratified by the presence or absence of calcs.

Results: Calcs were identified in 2063 (42.8%) biopsies. Calcs were associated with older age at BBD diagnosis (56.2 versus 49.0 years; P < 0.001). Overall, the risk of developing IBC or DCIS did not differ significantly between patients with calcs (HR 1.13, 95% CI 0.90, 1.41) as compared to patients without calcs. Stratification by BBD severity or subtype, age at BBD biopsy, outcomes of IBC versus DCIS, and mammography technique (screen-film versus full-field digital mammography) did not significantly alter association between calcs and risk.

Conclusion: Our analysis of calcs in BBD biopsies did not find a significant association between calcs and risk of breast cancer.

目的:描述微钙化(calcifications)与良性乳腺疾病病变亚型的关系,并评估组织钙化是否会影响导管原位癌(DCIS)和浸润性乳腺癌(IBC)的风险:我们分析了来自单个机构队列(2002-2013年)的4819例BBD活检的详细组织病理学数据,病例(N = 338)的DCIS或IBC随访中位数为7.4年,对照组为11.2年。根据病理报告,采用自然语言处理技术识别含有钙化物的活检样本。应用单变量和多变量回归模型评估与BBD病变类型的相关性,并进行年龄调整后的Cox比例危险回归,以根据是否存在钙化物对IBC或DCIS的风险进行分层建模:结果:在2063例(42.8%)活检中发现了钙化。钙化与BBD诊断年龄较大有关(56.2岁对49.0岁;P 结论:我们对BBD中的钙化进行了分析:我们对 BBD 活检组织中的钙化组织进行的分析并未发现钙化组织与乳腺癌风险之间存在显著关联。
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引用次数: 0
Tumor-infiltrating lymphocytes as a prognostic biomarker in patients with ductal carcinoma in situ of the breast: Correspondence. 作为乳腺导管原位癌患者预后生物标志物的肿瘤浸润淋巴细胞:通讯。
IF 3 3区 医学 Q2 ONCOLOGY Pub Date : 2024-12-01 Epub Date: 2024-09-24 DOI: 10.1007/s10549-024-07489-2
Hinpetch Daungsupawong, Viroj Wiwanitkit
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引用次数: 0
Is axillary web syndrome a risk factor for breast cancer-related lymphedema of the upper extremity? A systematic review and meta-analysis. 腋窝网综合征是乳腺癌相关上肢淋巴水肿的危险因素吗?系统回顾和荟萃分析。
IF 3 3区 医学 Q2 ONCOLOGY Pub Date : 2024-12-01 Epub Date: 2024-10-16 DOI: 10.1007/s10549-024-07518-0
Cheryl L Brunelle, Angela Serig

Purpose: To systematically review the available literature to determine if axillary web syndrome (AWS) is a risk factor for breast cancer-related lymphedema (BCRL) of the upper extremity.

Methods: The study is Prospero-registered (ID CRD42024508169) and follows PRISMA guidelines. Ovid MEDLINE, PubMED, CINAHL, Embase, clinicaltrials.gov and the WHO International Clinical Trials Registry Platform were searched February 24, 2024. Original studies including a cohort of females > 18 years of age diagnosed with AWS after breast cancer surgery and assessing BCRL outcome were included. Scoping, mapping, systematic or qualitative reviews, dissertations without peer-review and conference abstracts were excluded. Methodological quality was assessed using the Modified Downs and Black Checklist and overall certainty in the body of evidence was assessed using Cochrane's GRADE criteria (Grading of Recommendations Assessment, Development and Evaluation).

Results: Nine cohort studies representing 3218 participants were included. The median incidence of AWS and BCRL was 31.79% (IQR 8.90%) and 14.29% (IQR 19.01%), respectively, across all studies. Pooled analysis indicated an odds ratio of 1.19 (95% confidence interval 0.60,2.37), with substantial heterogeneity across studies (Chi2 p < 0.0001, I2 = 82%). Methodological quality of the included studies was poor to fair, and there was very low certainty evidence indicating no difference in AWS for BCRL risk. The strongest study included, found that AWS more than doubles BCRL risk in the upper extremity.

Conclusion: The available evidence base cannot definitively determine whether AWS imparts risk of BCRL. AWS should be considered a potential risk factor for BCRL, until definitive conclusions from future research are available.

目的:系统回顾现有文献,确定腋窝网综合征(AWS)是否是上肢乳腺癌相关淋巴水肿(BCRL)的危险因素:本研究已在 Prospero 注册(ID CRD42024508169),并遵循 PRISMA 指南。于 2024 年 2 月 24 日检索了 Ovid MEDLINE、PubMED、CINAHL、Embase、clinicaltrials.gov 和世界卫生组织国际临床试验注册平台。纳入的原始研究包括年龄大于 18 岁、在乳腺癌手术后诊断为 AWS 并评估 BCRL 结果的女性队列。不包括范围界定、绘图、系统或定性综述、未经同行评审的论文和会议摘要。采用改良的唐斯和布莱克核对表评估方法学质量,并采用 Cochrane 的 GRADE 标准(建议评估、发展和评价分级)评估证据体的总体确定性:结果:共纳入了九项队列研究,代表了 3218 名参与者。在所有研究中,AWS 和 BCRL 的中位发病率分别为 31.79%(IQR 8.90%)和 14.29%(IQR 19.01%)。汇总分析表明,几率比为 1.19(95% 置信区间为 0.60,2.37),不同研究之间存在很大的异质性(Chi2 p 2 = 82%)。纳入研究的方法学质量从较差到一般,有极低确定性的证据表明,AWS 对 BCRL 风险没有影响。所纳入的最有力的研究发现,AWS 可使上肢 BCRL 风险增加一倍以上:现有的证据基础无法明确确定 AWS 是否会带来 BCRL 风险。在未来的研究得出明确结论之前,应将 AWS 视为 BCRL 的潜在风险因素。
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引用次数: 0
Patient characteristics and treatment patterns of patients with locally advanced or metastatic HER2-low breast cancer, a single site descriptive study. 局部晚期或转移性 HER2 低水平乳腺癌患者的特征和治疗模式,一项单点描述性研究。
IF 3 3区 医学 Q2 ONCOLOGY Pub Date : 2024-12-01 Epub Date: 2024-08-22 DOI: 10.1007/s10549-024-07458-9
Connor Willis, Chia Jie Tan, Anindit Chhibber, Alexandre H Watanabe, Clara Lam, Sandhya Mehta, Jackie Kwong, Leah Park, Melissa Pavilack-Kirker, Xiaoqing Xu, Kristen Kelley, David Stenehjem

Purpose: To evaluate the prevalence and characteristics of different HER2 categories among patients with advanced breast cancer (aBC) and describe treatment patterns and outcomes of those with HER2-low disease.

Methods: A retrospective cohort study was conducted via chart review at the Huntsman Cancer Institute, including patients diagnosed with aBC (stages IIIB, IIIC and IV) between 2010 and 2019. All patients with IHC1+ were considered HER2-low unless FISH was positive. Patients with IHC2+ were only classified as HER2-low if a negative FISH was documented. The prevalence and characteristics of each HER2 category were reported. Treatment patterns and survival outcomes of HER2-low patients who received first line treatment in 2017 or later were presented.

Results: A total of 240 of 414 patients (58%) with aBC were HER2-low, with the majority of patients (83%) classified as hormone receptor (HR)-positive. In first line, most HR-positive patients received endocrine therapy with chemotherapy for stage IIIB/IIIC (47%) and with CDK4/6 inhibitors for stage IV breast cancer (50%) Most HR-negative patients received chemotherapy alone (92% for stage IIIB/IIIC, 60% for stage IV). In second line, chemotherapy alone was the most common modality (21.4% for HR-positive; 45.5% for HR-negative). Median overall survival was 37.7 months while median progression-free survival from first line was 18.0 months, decreasing to 8.0 months in second line.

Conclusion: A substantial proportion of patients previously classified as HER2-negative have low but detectable HER2 expression and may benefit from novel HER2-directed agents, which have demonstrated clinical benefit in this population post-chemotherapy.

目的:评估晚期乳腺癌(aBC)患者中不同HER2类别的患病率和特征,并描述HER2低的患者的治疗模式和结果:亨斯迈癌症研究所通过病历审查开展了一项回顾性队列研究,研究对象包括2010年至2019年期间确诊的aBC(IIIB、IIIC和IV期)患者。所有 IHC1+ 患者均被视为 HER2 低,除非 FISH 呈阳性。IHC2+患者只有在FISH阴性的情况下才会被归类为HER2-low。报告了每个 HER2 类别的患病率和特征。报告了2017年或之后接受一线治疗的HER2-low患者的治疗模式和生存结果:在414例aBC患者中,共有240例(58%)为HER2低,其中大部分患者(83%)被归类为激素受体(HR)阳性。在一线治疗中,大多数 HR 阳性患者接受内分泌治疗,IIIB/IIIC 期患者接受化疗(47%),IV 期乳腺癌患者接受 CDK4/6 抑制剂治疗(50%),大多数 HR 阴性患者仅接受化疗(IIIB/IIIC 期 92%,IV 期 60%)。在二线治疗中,单纯化疗是最常见的方式(HR 阳性患者为 21.4%;HR 阴性患者为 45.5%)。中位总生存期为37.7个月,一线治疗的中位无进展生存期为18.0个月,二线治疗的中位无进展生存期降至8.0个月:结论:相当一部分以前被归类为HER2阴性的患者具有较低但可检测到的HER2表达,他们可能会从新型HER2导向药物中获益,这些药物已在化疗后的这类人群中显示出临床获益。
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引用次数: 0
Phenotypes of carriers of two mutated alleles in major cancer susceptibility genes. 主要癌症易感基因中两个突变等位基因携带者的表型。
IF 3 3区 医学 Q2 ONCOLOGY Pub Date : 2024-12-01 Epub Date: 2024-08-05 DOI: 10.1007/s10549-024-07454-z
Yael Laitman, Anni Niskakoski, Rinal Bernstein-Molho, Lotta Koskinen, Daniel Rabina, Juha Koskenvuo, Eitan Friedman

Purpose: While cancer phenotypes in carriers of a single mutant allele in most major cancer susceptibility genes are well-established, there is a paucity of data on the phenotype of carriers of two pathogenic variants-double heterozygotes (DH) or homozygous carriers. Here, we describe the phenotype of carriers of homozygous and DH pathogenic sequence variants (PSVs) in major cancer susceptibility genes.

Methods: Individuals referred for multigene panel testing at Blueprint Genetics laboratory were included. Ethically approved comparison of cancer type and age at diagnosis between DH, homozygous, and single PSV carriers was performed per gene.

Results: Of 6,685 eligible participants, 928 (13.9%) were single heterozygous PSV carriers, 6 (0.09%) were homozygous PSV carriers, and 17 (0.25%) were DH PSV carriers. Mean age at diagnosis of any cancer among single PSV age was 46.8 ± 14.9 years and among DH PSV carriers 37.6 ± 13.0 years (P < 0.0001). Notably, age at diagnosis for breast cancer among single BRCA1 PSV carriers (n = 59) was 43.8 ± 8.7 years (p = 0.7606), among single BRCA2 PSV carriers (n = 52)-47.9 ± 13.0 years (p = 0.2274) compared with 42.3 ± 13.0 years among DH PSV carriers (n = 10- 9 of whom were carriers of either BRCA1 or BRCA2).

Conclusion: DH for PSV in two cancer susceptibility genes is a rare event, and the mean age at cancer diagnosis is younger in DH PSV carriers compared with single PSV carriers.

目的:虽然大多数主要癌症易感基因中单个突变等位基因携带者的癌症表型已得到证实,但有关两个致病变体携带者--双杂合子(DH)或同基因携带者--表型的数据却很少。在此,我们描述了主要癌症易感基因中同源和 DH 致病序列变异(PSVs)携带者的表型:方法:纳入转诊到蓝图基因实验室进行多基因面板检测的个体。结果:在 6,685 名符合条件的参与者中,DH、同基因和单个 PSV 携带者的癌症类型和诊断年龄的比较获得了伦理批准:在 6,685 名符合条件的参与者中,928 人(13.9%)为单杂合子 PSV 携带者,6 人(0.09%)为同基因 PSV 携带者,17 人(0.25%)为 DH PSV 携带者。单基因 PSV 携带者确诊任何癌症的平均年龄为(46.8 ± 14.9)岁,DH PSV 携带者的平均年龄为(37.6 ± 13.0)岁:两个癌症易感基因中 PSV 的 DH 是一种罕见情况,与单 PSV 携带者相比,DH PSV 携带者的癌症确诊平均年龄更小。
{"title":"Phenotypes of carriers of two mutated alleles in major cancer susceptibility genes.","authors":"Yael Laitman, Anni Niskakoski, Rinal Bernstein-Molho, Lotta Koskinen, Daniel Rabina, Juha Koskenvuo, Eitan Friedman","doi":"10.1007/s10549-024-07454-z","DOIUrl":"10.1007/s10549-024-07454-z","url":null,"abstract":"<p><strong>Purpose: </strong>While cancer phenotypes in carriers of a single mutant allele in most major cancer susceptibility genes are well-established, there is a paucity of data on the phenotype of carriers of two pathogenic variants-double heterozygotes (DH) or homozygous carriers. Here, we describe the phenotype of carriers of homozygous and DH pathogenic sequence variants (PSVs) in major cancer susceptibility genes.</p><p><strong>Methods: </strong>Individuals referred for multigene panel testing at Blueprint Genetics laboratory were included. Ethically approved comparison of cancer type and age at diagnosis between DH, homozygous, and single PSV carriers was performed per gene.</p><p><strong>Results: </strong>Of 6,685 eligible participants, 928 (13.9%) were single heterozygous PSV carriers, 6 (0.09%) were homozygous PSV carriers, and 17 (0.25%) were DH PSV carriers. Mean age at diagnosis of any cancer among single PSV age was 46.8 ± 14.9 years and among DH PSV carriers 37.6 ± 13.0 years (P < 0.0001). Notably, age at diagnosis for breast cancer among single BRCA1 PSV carriers (n = 59) was 43.8 ± 8.7 years (p = 0.7606), among single BRCA2 PSV carriers (n = 52)-47.9 ± 13.0 years (p = 0.2274) compared with 42.3 ± 13.0 years among DH PSV carriers (n = 10- 9 of whom were carriers of either BRCA1 or BRCA2).</p><p><strong>Conclusion: </strong>DH for PSV in two cancer susceptibility genes is a rare event, and the mean age at cancer diagnosis is younger in DH PSV carriers compared with single PSV carriers.</p>","PeriodicalId":9133,"journal":{"name":"Breast Cancer Research and Treatment","volume":" ","pages":"589-595"},"PeriodicalIF":3.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11522137/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141888443","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Oral minoxidil for late alopecia in cancer survivors. 口服米诺地尔治疗癌症幸存者的晚期脱发。
IF 3 3区 医学 Q2 ONCOLOGY Pub Date : 2024-12-01 Epub Date: 2024-08-04 DOI: 10.1007/s10549-024-07440-5
Alyce Mei-Shiuan Kuo, Rachel E Reingold, Kwami F Ketosugbo, Alexander Pan, Lukas Kraehenbuehl, Stephen Dusza, Devika Gajria, Diana E Lake, Jacqueline F Bromberg, Tiffany A Traina, Monica N Fornier, Ayca Gucalp, Brian M D'Alessandro, Veronica Rotemberg, Megan Dauscher, Jerry Shapiro, Shari B Goldfarb, Alina Markova, Mario E Lacouture

Purpose: Late alopecia, defined as incomplete hair regrowth > 6 months following cytotoxic chemotherapy or > 6 months from initiation of endocrine therapy, negatively impacts quality of life and may affect dose intensity of adjuvant therapy. This study investigates the effect of oral minoxidil in women with chemotherapy and/or endocrine therapy-induced late alopecia.

Methods: The rate of clinical response was assessed by standardized photography and quantitated with trichoscopy.

Results: Two hundred and sixteen patients (mean age 57.8 ± 13.7) were included. The most common cancer diagnosis was breast, in 170 patients (79.1%). Alopecia developed after chemotherapy in 31 (14.4%) patients, endocrine monotherapy in 65 (30.1%) patients, and chemotherapy followed by endocrine therapy in 120 (55.6%) patients. In 119 patients, standardized photography assessments were used to determine clinical change in alopecia after a median of 105 (IQR = 70) days on oral minoxidil and revealed improvement in 88 (74%) patients. Forty-two patients received quantitative trichoscopic assessments at baseline and at follow-up after a median of 91 (IQR = 126) days on oral minoxidil. Patients had clinically and statistically significant increases in frontal hair shaft density (from 124.2 hairs/cm2 at initial to 153.2 hairs/cm2 at follow-up assessment, p = 0.008) and occipital shaft density (from 100.3 hairs/cm2 at initial to 123.5 hairs/cm2 at follow-up assessment. p = 0.004). No patients discontinued oral minoxidil due to adverse events.

Conclusions: Overall, oral minoxidil was well tolerated by patients and may benefit both frontal and occipital late alopecia in cancer survivors treated with cytotoxic and/or endocrine therapy by increasing hair shaft and follicle density.

目的:晚期脱发是指细胞毒性化疗后 6 个月以上或内分泌治疗开始后 6 个月以上头发未完全再生,对生活质量有负面影响,并可能影响辅助治疗的剂量强度。本研究探讨了口服米诺地尔对化疗和/或内分泌治疗引起的晚期脱发妇女的影响:方法:通过标准化摄影评估临床反应率,并用毛囊镜进行量化:结果:共纳入 216 名患者(平均年龄为 57.8±13.7 岁)。最常见的癌症诊断是乳腺癌,有 170 名患者(79.1%)。31例(14.4%)患者在化疗后出现脱发,65例(30.1%)患者在单用内分泌治疗后出现脱发,120例(55.6%)患者在化疗后接受内分泌治疗。119例患者在口服米诺地尔中位数为105天(IQR=70天)后,采用标准化摄影评估来确定脱发的临床变化,结果显示88例(74%)患者的脱发有所改善。42 名患者在口服米诺地尔 91 天(IQR = 126 天)后的基线和随访期间接受了定量毛发镜评估。患者的额部毛干密度(从最初的 124.2 根头发/平方厘米增加到随访评估时的 153.2 根头发/平方厘米,p = 0.008)和枕部毛干密度(从最初的 100.3 根头发/平方厘米增加到随访评估时的 123.5 根头发/平方厘米,p = 0.004)均有临床和统计学意义上的显著增加。没有患者因不良反应而停止口服米诺地尔:总体而言,患者对口服米诺地尔的耐受性良好,而且可以通过增加发轴和毛囊密度,使接受细胞毒性和/或内分泌治疗的癌症幸存者的额部和枕部晚期脱发患者受益。
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引用次数: 0
Letter to the editor: "Frequency of zoledronate administration in early breast cancer". 致编辑的信:"早期乳腺癌患者服用唑来膦酸钠的频率"。
IF 3 3区 医学 Q2 ONCOLOGY Pub Date : 2024-12-01 Epub Date: 2024-09-04 DOI: 10.1007/s10549-024-07490-9
Wei-Zhen Tang, Wen-Xing Deng, Tai-Hang Liu
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引用次数: 0
Alterations in the expression of homologous recombination repair (HRR) genes in breast cancer tissues considering germline BRCA1/2 mutation status. 考虑到生殖系 BRCA1/2 基因突变状态,乳腺癌组织中同源重组修复 (HRR) 基因表达的变化。
IF 3 3区 医学 Q2 ONCOLOGY Pub Date : 2024-12-01 Epub Date: 2024-07-30 DOI: 10.1007/s10549-024-07441-4
Izabela Laczmanska, Rafal Matkowski, Stanislaw Supplitt, Pawel Karpinski, Mariola Abrahamowska, Lukasz Laczmanski, Adam Maciejczyk, Ewelina Czykalko, Ewelina Iwaneczko, Piotr Kasprzak, Bartłomiej Szynglarewicz, Maria Sasiadek

Introduction: Homologous recombination (HR) is a crucial DNA-repair mechanism, and its disruption can lead to the accumulation of mutations that initiate and promote cancer formation. The key HR genes, BRCA1 and BRCA2, are particularly significant as their germline pathogenic variants are associated with a hereditary predisposition to breast and/or ovarian cancer.

Materials and methods: The study was performed on 45 FFPE breast cancer tissues obtained from 24 and 21 patients, with and without the germline BRCA1/2 mutation, respectively. The expression of 11 genes: BRCA1, BRCA2, ATM, BARD1, FANCA, FANCB, FANCI, RAD50, RAD51D, BRIP1, and CHEK2 was assessed using Custom RT2 PCR Array (Qiagen), and results were analysed using R.

Results: Cancer tissues from patients with BRCA1 or BRCA2 germline mutations displayed no significant differences in the expression of the selected HR genes compared to BRCA1 or BRCA2 wild-type cancer tissues. In BRCA1mut cancer tissues, BRCA1 expression was significantly higher than in BRCA2mut and BRCA wild-type cancer tissues.

Conclusions: In cancer tissues harbouring either BRCA1 or BRCA2 germline mutations, no significant differences in expression were observed at the mRNA level of any tested HR genes, except BRCA1. However, the significant differences observed in BRCA1 expression between germline BRCA1mut, germline BRCA2mut and BRCA1/2wt tissues may indicate a compensatory mechanism at the mRNA level to mitigate the loss of BRCA1 function in the cells.

简介同源重组(HR)是一种重要的 DNA 修复机制,它的破坏会导致突变的积累,从而引发和促进癌症的形成。关键的 HR 基因 BRCA1 和 BRCA2 尤为重要,因为它们的种系致病变异与乳腺癌和/或卵巢癌的遗传易感性有关:该研究对 45 个 FFPE 乳腺癌组织进行了分析,这些组织分别来自 24 名和 21 名有和没有 BRCA1/2 基因突变的患者。共检测了 11 个基因的表达:使用定制 RT2 PCR 阵列(Qiagen)评估了 BRCA1、BRCA2、ATM、BARD1、FANCA、FANCB、FANCI、RAD50、RAD51D、BRIP1 和 CHEK2 等 11 个基因的表达情况,并使用 R 对结果进行了分析:结果:与BRCA1或BRCA2野生型癌症组织相比,BRCA1或BRCA2种系突变患者的癌症组织在所选HR基因的表达上没有明显差异。在 BRCA1 基因突变的癌症组织中,BRCA1 的表达明显高于 BRCA2 基因突变和 BRCA 野生型癌症组织:结论:在携带 BRCA1 或 BRCA2 基因突变的癌症组织中,除 BRCA1 外,未观察到任何受测 HR 基因的 mRNA 表达水平存在显著差异。然而,在BRCA1突变种系、BRCA2突变种系和BRCA1/2wt组织之间观察到的BRCA1表达量的显著差异可能表明在mRNA水平上存在一种补偿机制,以减轻细胞中BRCA1功能的丧失。
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引用次数: 0
Efficacy of antiobesity medications among breast cancer survivors taking aromatase inhibitors. 服用芳香化酶抑制剂的乳腺癌幸存者服用抗肥胖药物的疗效。
IF 3 3区 医学 Q2 ONCOLOGY Pub Date : 2024-12-01 Epub Date: 2024-07-30 DOI: 10.1007/s10549-024-07450-3
Sima Fansa, Wissam Ghusn, Elif Tama, Bryan Nicolalde, Diego Anazco, Stacy D ' Andre, Stephanie S Faubion, Chrisandra L Shufelt, Andres Acosta, Maria D Hurtado Andrade

Purpose: Aromatase inhibitors (AI) block estrogen synthesis and are used as long-term adjuvant treatment for breast cancer in postmenopausal women. AI use can be associated with weight gain that can lead to increased cardiometabolic risk. The response to anti-obesity medications (AOM) in patients using AI has yet to be studied. We sought to investigate weight loss outcomes of AOM in patients taking AI for breast cancer treatment.

Methods: This is a matched retrospective cohort study of breast cancer survivors on AI using AOM (AOM/AI group). We compared their weight loss outcomes with a group of female patients with obesity, without a history of breast cancer or AI use, on AOM (AOM group). The primary endpoint was total body weight loss percentage (TBWL %) at the last follow-up. We performed mixed linear regression models, including diabetes status at baseline, to assess associations between use of AOM with/without AI with total body weight loss percentage (TBWL%).

Results: We included 124 patients: 62 in the AOM/AI group (63.6 ± 10 years, body mass index [BMI] 34.3 ± 7.1 kg/m2) and 62 in the AOM group (62.8 ± 9.9 years, BMI 34.6 ± 6.5 kg/m2). The mean time of follow up was 9.3 ± 3.5 months, with no differences among the two groups. The AOM/AI group had a lower TBWL% compared to the AOM group at the last follow-up -5.3 ± 5.0 vs. -8.2 ± 6.3 (p = 0.005). The results remained significant after adjusting for diabetes status (p = 0.0002). At 12 months, the AOM/AI group had a lower TBWL% compared to the AOM group 6.4 ± 0.8% vs. 9.8 ± 0.9% (p = 0.04). The percentage of patients achieving ≥ 5%, ≥ 10%, and ≥ 15% of weight loss at 12 months was greater in the AOM compared to the AOM/AI group. Although the weight loss response was suboptimal, patients in the AOM/AI group had improvement in fasting glucose, glycated hemoglobin, systolic blood pressure, and low-density lipoprotein cholesterol.

Conclusions: The use of AI in breast cancer survivors is associated with less weight loss response to AOM compared to patients without breast cancer history and who do not take AI. Studies are needed to assess the mechanisms behind the differential weight loss response to AOM in women taking AI.

目的:芳香化酶抑制剂(AI)可阻断雌激素的合成,是绝经后妇女乳腺癌的长期辅助治疗药物。使用 AI 可能会导致体重增加,从而增加心脏代谢风险。目前尚未研究使用 AI 的患者对抗肥胖药物(AOM)的反应。我们试图研究服用抗肥胖药物治疗乳腺癌患者的减肥效果:这是一项匹配的回顾性队列研究,研究对象是使用 AOM 的 AI 乳腺癌幸存者(AOM/AI 组)。我们将她们的体重减轻结果与一组没有乳腺癌病史或使用过 AI 的肥胖女性患者(AOM 组)进行了比较。主要终点是最后一次随访时的总体重减轻百分比(TBWL %)。我们建立了混合线性回归模型,包括基线时的糖尿病状况,以评估使用AOM(含/不含AI)与总体重减轻百分比(TBWL%)之间的关系:我们共纳入了 124 名患者:AOM/AI组62人(63.6 ± 10岁,体重指数[BMI] 34.3 ± 7.1 kg/m2),AOM组62人(62.8 ± 9.9岁,体重指数34.6 ± 6.5 kg/m2)。平均随访时间为 9.3 ± 3.5 个月,两组之间无差异。在最后一次随访时,AOM/AI 组的 TBWL% 比 AOM 组低 -5.3 ± 5.0 vs. -8.2 ± 6.3(p = 0.005)。在调整糖尿病状态后,结果仍然显著(p = 0.0002)。12个月时,AOM/AI组的TBWL%低于AOM组(6.4 ± 0.8% vs. 9.8 ± 0.9%)(p = 0.04)。与AOM/AI组相比,AOM组在12个月内体重减轻≥5%、≥10%和≥15%的患者比例更高。虽然体重减轻反应不理想,但AOM/AI组患者的空腹血糖、糖化血红蛋白、收缩压和低密度脂蛋白胆固醇均有所改善:结论:与无乳腺癌病史且未服用人工受体阻断剂的患者相比,乳腺癌幸存者服用人工受体阻断剂后对AOM的体重减轻反应较小。需要进行研究,以评估服用AI的妇女对AOM的不同减肥反应背后的机制。
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引用次数: 0
Variation in surgical treatment by body mass index in patients with invasive lobular carcinoma of the breast. 浸润性乳腺小叶癌患者的手术治疗因体重指数而异。
IF 3 3区 医学 Q2 ONCOLOGY Pub Date : 2024-12-01 Epub Date: 2024-08-11 DOI: 10.1007/s10549-024-07452-1
Israel O Falade, Kayla M Switalla, Molly E Baxter, Astrid Quirarte, Helena Record, Harriet T Rothschild, Elle N Clelland, Rita A Mukhtar

Purpose: Patients with invasive lobular carcinoma (ILC) face high rates of positive margins and completion mastectomy, which can be improved with the use of specific techniques, such as oncoplastic surgery. However, prior studies have shown that type of breast cancer surgery performed is also associated with patient factors such as elevated body mass index (BMI). Thus, this study investigates whether BMI impacts the type of surgical interventions in patients with ILC.

Methods: A retrospective analysis of 705 patients with stage I-III ILC from an institutional database was conducted. Patients were stratified by BMI (underweight, normal weight, overweight, obese). Pearson's Chi-square, ANOVA, and multivariable logistic regression were used to evaluate the relationship between BMI and surgical procedures.

Results: Breast-conserving surgery (BCS) was the initial operation in 60% of patients, with no significant difference by BMI. Among those undergoing BCS, patients with obese BMI were significantly more likely to undergo oncoplastic surgery (46.9% vs. 7.7%, 37.3%, and 33.6% for underweight, normal, and overweight, respectively, p = 0.032). Obese BMI patients undergoing mastectomy were less likely to have reconstruction compared to those with underweight, normal weight, and overweight BMI (44.2% vs. 50%, 71.1%, and 64.1%, p = 0.002).

Conclusion: Overweight/obese BMI patients with ILC underwent different surgical interventions compared to those with lower BMI. While initial BCS rates were similar, overweight/obese patients had higher oncoplastic surgery rates in BCS and lower reconstruction rates in mastectomy. Further research is needed to understand BMI's impact on surgical decisions and outcomes in ILC.

目的:浸润性小叶癌(ILC)患者的边缘阳性率和乳房切除术的完成率都很高,使用肿瘤整形手术等特殊技术可以改善这一情况。然而,之前的研究表明,乳腺癌手术的类型也与患者的身体质量指数(BMI)升高等因素有关。因此,本研究调查了体重指数是否会影响 ILC 患者的手术干预类型:方法:研究人员对某机构数据库中的 705 名 I-III 期 ILC 患者进行了回顾性分析。根据体重指数(体重不足、正常体重、超重、肥胖)对患者进行分层。采用皮尔逊卡方、方差分析和多变量逻辑回归评估 BMI 与手术治疗之间的关系:结果:60%的患者最初接受的手术是保乳手术(BCS),BMI没有明显差异。在接受保乳手术的患者中,肥胖 BMI 患者接受肿瘤整形手术的几率明显更高(46.9% 对比起体重不足、正常和超重的 7.7%、37.3% 和 33.6%,P = 0.032)。与体重不足、体重正常和体重超重的患者相比,接受乳房切除术的肥胖 BMI 患者接受乳房重建的可能性较低(44.2% vs. 50%、71.1% 和 64.1%,P = 0.002):结论:与体重指数较低的患者相比,超重/肥胖体重指数(BMI)的ILC患者接受了不同的手术干预。虽然最初的乳房肿块切除率相似,但超重/肥胖患者接受乳房肿块切除术的肿瘤整形手术率较高,接受乳房切除术的乳房重建率较低。要了解BMI对ILC手术决策和结果的影响,还需要进一步的研究。
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Breast Cancer Research and Treatment
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