Pub Date : 2024-12-01Epub Date: 2024-08-14DOI: 10.1007/s10549-024-07457-w
Zihan Melink, Maryam B Lustberg, Patrick M Schnell, Jessica Mezzanotte-Sharpe, Tonya S Orchard
Purpose: Minocycline suppresses chemotherapy-induced neuroinflammation in preclinical models, but its effects in cancer survivors are unknown. This study evaluated the longitudinal effects of minocycline on affective behaviors, cognitive functions, and inflammation in women with breast cancer (BC) undergoing chemotherapy.
Methods: This is a pilot, double-blind, randomized controlled trial of oral minocycline (100 mg BID) versus placebo for chemotherapy-induced affective disorders in women initiating chemotherapy for stage I-III BC. Participants received minocycline or placebo up to one week before chemotherapy, continuing through cycle 4 (C4). Epidemiologic Studies Depression Scale (CES-D) and State-Trait Anxiety Inventory (STAI) were assessed at baseline, each cycle of chemotherapy (C1-C4), 2-3-week post-chemotherapy (end of chemotherapy), and 6-month post-chemotherapy (6 M) as the primary outcomes. Sub-group analysis of CES-D and STAI based on the severity of symptoms was also performed. Changes in self-reported cognition and serum inflammatory markers were also evaluated.
Results: Fifty-seven women enrolled and 55 completed the study. Except for Interleukin-8 (p ≤ 0.03), changes in inflammatory markers, cognitive function, CES-D, and STAI were not significantly different between groups from baseline to any cycle or post-chemotherapy time point (all p > 0.05), adjusting for baseline scores. Increases in serum Interleukin-8 from baseline to C4 and 6 M were ameliorated by minocycline (p < 0.05). The sub-group symptomatic for depression (CES-D > = 16 at baseline) treated with minocycline had a greater reduction in CES-D score compared to placebo from baseline to 6 M (p = 0.01).
Conclusion: Despite attenuation of IL-8, minocycline did not alter self-reported affective symptoms or cognition in this cohort of BC survivors undergoing chemotherapy. The effect of minocycline on BC survivors symptomatic for depression before chemotherapy warrants further investigation.
{"title":"Effect of minocycline on changes in affective behaviors, cognitive function, and inflammation in breast cancer survivors undergoing chemotherapy: a pilot randomized controlled trial.","authors":"Zihan Melink, Maryam B Lustberg, Patrick M Schnell, Jessica Mezzanotte-Sharpe, Tonya S Orchard","doi":"10.1007/s10549-024-07457-w","DOIUrl":"10.1007/s10549-024-07457-w","url":null,"abstract":"<p><strong>Purpose: </strong>Minocycline suppresses chemotherapy-induced neuroinflammation in preclinical models, but its effects in cancer survivors are unknown. This study evaluated the longitudinal effects of minocycline on affective behaviors, cognitive functions, and inflammation in women with breast cancer (BC) undergoing chemotherapy.</p><p><strong>Methods: </strong>This is a pilot, double-blind, randomized controlled trial of oral minocycline (100 mg BID) versus placebo for chemotherapy-induced affective disorders in women initiating chemotherapy for stage I-III BC. Participants received minocycline or placebo up to one week before chemotherapy, continuing through cycle 4 (C4). Epidemiologic Studies Depression Scale (CES-D) and State-Trait Anxiety Inventory (STAI) were assessed at baseline, each cycle of chemotherapy (C1-C4), 2-3-week post-chemotherapy (end of chemotherapy), and 6-month post-chemotherapy (6 M) as the primary outcomes. Sub-group analysis of CES-D and STAI based on the severity of symptoms was also performed. Changes in self-reported cognition and serum inflammatory markers were also evaluated.</p><p><strong>Results: </strong>Fifty-seven women enrolled and 55 completed the study. Except for Interleukin-8 (p ≤ 0.03), changes in inflammatory markers, cognitive function, CES-D, and STAI were not significantly different between groups from baseline to any cycle or post-chemotherapy time point (all p > 0.05), adjusting for baseline scores. Increases in serum Interleukin-8 from baseline to C4 and 6 M were ameliorated by minocycline (p < 0.05). The sub-group symptomatic for depression (CES-D > = 16 at baseline) treated with minocycline had a greater reduction in CES-D score compared to placebo from baseline to 6 M (p = 0.01).</p><p><strong>Conclusion: </strong>Despite attenuation of IL-8, minocycline did not alter self-reported affective symptoms or cognition in this cohort of BC survivors undergoing chemotherapy. The effect of minocycline on BC survivors symptomatic for depression before chemotherapy warrants further investigation.</p>","PeriodicalId":9133,"journal":{"name":"Breast Cancer Research and Treatment","volume":null,"pages":null},"PeriodicalIF":3.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11522141/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141981712","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}
Pub Date : 2024-11-04DOI: 10.1007/s10549-024-07531-3
Amulya Vadlakonda, Nikhil L Chervu, Giselle Porter, Sara Sakowitz, Hanjoo Lee, Peyman Benharash, Nimmi S Kapoor
Background: As the US faces a diverse aging population, racial disparities in breast cancer outcomes among elderly patients remain poorly understood. We evaluate the association of race with presenting stage, treatment, and survival of invasive breast cancer among octogenarians.
Methods: Women (≥ 80 years) with invasive breast cancer were identified in 2004-2020 NCDB. To facilitate comparison, only non-Hispanic Black and non-Hispanic White patients were included; patients of Hispanic ethnicity were excluded. Demographics, tumor characteristics, and treatments were assessed by race. Overall survival was compared using the logrank test. Multivariable logistic and Cox proportional hazard regression models were developed to evaluate the independent association of race with outcomes of interest.
Results: Of 222,897 patients, 19,059 (8.6%) were Black. Most patients had stage I ER + HER2- invasive ductal carcinoma. Black patients more frequently had greater comorbidities, low income and education, and advanced stage (p < 0.001 each; ref: White). Following adjustment, Black women had increased likelihood of Stage III/IV over time, as well as increased odds of chemotherapy (AOR 1.22, 95% CI 1.15 - 1.29) and non-operative management (AOR 1.82, 95% CI 1.72 - 1.92; ref: White). Although Black patients had lower survival rates compared to White, race was not associated with 5-year mortality following adjustment for stage, receipt of surgery, and adjuvant treatments (p = 0.34).
Conclusions: Inferior survival among elderly Black patients appears be driven by advanced stage at presentation. While such disparities are narrowing in the present era, future work must consider upstream interventions to ensure equitable outcomes for all races.
{"title":"Racial disparities in presenting stage and surgical management among octogenarians with breast cancer: a national cancer database analysis.","authors":"Amulya Vadlakonda, Nikhil L Chervu, Giselle Porter, Sara Sakowitz, Hanjoo Lee, Peyman Benharash, Nimmi S Kapoor","doi":"10.1007/s10549-024-07531-3","DOIUrl":"https://doi.org/10.1007/s10549-024-07531-3","url":null,"abstract":"<p><strong>Background: </strong>As the US faces a diverse aging population, racial disparities in breast cancer outcomes among elderly patients remain poorly understood. We evaluate the association of race with presenting stage, treatment, and survival of invasive breast cancer among octogenarians.</p><p><strong>Methods: </strong>Women (≥ 80 years) with invasive breast cancer were identified in 2004-2020 NCDB. To facilitate comparison, only non-Hispanic Black and non-Hispanic White patients were included; patients of Hispanic ethnicity were excluded. Demographics, tumor characteristics, and treatments were assessed by race. Overall survival was compared using the logrank test. Multivariable logistic and Cox proportional hazard regression models were developed to evaluate the independent association of race with outcomes of interest.</p><p><strong>Results: </strong>Of 222,897 patients, 19,059 (8.6%) were Black. Most patients had stage I ER + HER2- invasive ductal carcinoma. Black patients more frequently had greater comorbidities, low income and education, and advanced stage (p < 0.001 each; ref: White). Following adjustment, Black women had increased likelihood of Stage III/IV over time, as well as increased odds of chemotherapy (AOR 1.22, 95% CI 1.15 - 1.29) and non-operative management (AOR 1.82, 95% CI 1.72 - 1.92; ref: White). Although Black patients had lower survival rates compared to White, race was not associated with 5-year mortality following adjustment for stage, receipt of surgery, and adjuvant treatments (p = 0.34).</p><p><strong>Conclusions: </strong>Inferior survival among elderly Black patients appears be driven by advanced stage at presentation. While such disparities are narrowing in the present era, future work must consider upstream interventions to ensure equitable outcomes for all races.</p>","PeriodicalId":9133,"journal":{"name":"Breast Cancer Research and Treatment","volume":null,"pages":null},"PeriodicalIF":3.0,"publicationDate":"2024-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142567075","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Purpose: This study aimed to assess the concordance of human epidermal growth factor receptor 2 (HER2) expression scoring by immunohistochemistry (IHC) among practicing pathologists in Japan, given the challenging nature of scoring and the critical role of HER2 status in breast cancer management.
Methods: Whole slide images (WSI) from 20 invasive breast cancer cases (1 representative WSI per case) selected to represent a diverse IHC scores and staining patterns were used in an online survey involving seven reference pathologists who established consensus HER2 IHC scores (0 to 3 +) decided by majority interpretation. Participating pathologists nationwide scored the same 20 WSI cases online using the American Society of Clinical Oncology/College of American Pathologists (ASCO/CAP) 2018 guidelines. Deidentified case metadata were registered in the uPath system.
Results: A total of 144 participating pathologists responded. The scoring results of the participating pathologists most commonly agreed with the consensus IHC score, followed by a ± 1 point deviation and no survey responses with > 1 point deviation. The mean percentage of agreement with the consensus score for all 20 cases was 63.4%. In cases where the reference pathologists' scores were discordant, the participating pathologists also showed a lower concordance rate.
Conclusion: This study highlighted the current status of HER2 expression scoring by IHC for breast cancer among pathologists in Japan. These findings underscore the challenges in HER2 IHC scoring cases and emphasize the need for improved standardization and training, especially in the evolving landscape of HER2-targeted therapies.
{"title":"Current status and challenges in HER2 IHC assessment: scoring survey results in Japan.","authors":"Takashi Sakatani, Hitoshi Tsuda, Masayuki Yoshida, Naoko Honma, Shinobu Masuda, Tomo Osako, Amiko Hayashi, Ana Richelia Jara-Lazaro, Rie Horii","doi":"10.1007/s10549-024-07532-2","DOIUrl":"https://doi.org/10.1007/s10549-024-07532-2","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to assess the concordance of human epidermal growth factor receptor 2 (HER2) expression scoring by immunohistochemistry (IHC) among practicing pathologists in Japan, given the challenging nature of scoring and the critical role of HER2 status in breast cancer management.</p><p><strong>Methods: </strong>Whole slide images (WSI) from 20 invasive breast cancer cases (1 representative WSI per case) selected to represent a diverse IHC scores and staining patterns were used in an online survey involving seven reference pathologists who established consensus HER2 IHC scores (0 to 3 +) decided by majority interpretation. Participating pathologists nationwide scored the same 20 WSI cases online using the American Society of Clinical Oncology/College of American Pathologists (ASCO/CAP) 2018 guidelines. Deidentified case metadata were registered in the uPath system.</p><p><strong>Results: </strong>A total of 144 participating pathologists responded. The scoring results of the participating pathologists most commonly agreed with the consensus IHC score, followed by a ± 1 point deviation and no survey responses with > 1 point deviation. The mean percentage of agreement with the consensus score for all 20 cases was 63.4%. In cases where the reference pathologists' scores were discordant, the participating pathologists also showed a lower concordance rate.</p><p><strong>Conclusion: </strong>This study highlighted the current status of HER2 expression scoring by IHC for breast cancer among pathologists in Japan. These findings underscore the challenges in HER2 IHC scoring cases and emphasize the need for improved standardization and training, especially in the evolving landscape of HER2-targeted therapies.</p>","PeriodicalId":9133,"journal":{"name":"Breast Cancer Research and Treatment","volume":null,"pages":null},"PeriodicalIF":3.0,"publicationDate":"2024-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142575174","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Objective: To quantify the pressure levels necessary for effective Manual Lymphatic Drainage (MLD) in managing Breast Cancer-Related Lymphedema (BCRL) across various stages, and to contribute to the development of standardized protocols for MLD therapy.
Methods: The study included 42 patients with BCRL (Stages I-III) and 14 certified lymphedema therapists. Forearms and upper arm circumferences were measured pre and post a 21-day MLD intervention. A tactile sensor system recorded the applied pressure during treatment. The data were preprocessed and statistically analyzed to assess pressure patterns and their stage-specific impacts on lymphedema.
Results: The mean age of the patients was 52.4 years, and that of the therapists was 39.1 years. A statistically significant reduction in arm circumference was observed post-MLD treatment (P < 0.05). The pressure applied varied across stages: I forearm 16.5-20.1 mmHg, I upper arm 16.1-20.7 mmHg; II forearm 16.6-19.8 mmHg, II upper arm 19.7-23.8 mmHg; III forearm 29.3-34.3 mmHg, III upper arm 29.7-34.3 mmHg. No statistically significant difference was found between forearm and upper arm treatment pressures within Stages I (P = 0.283) and III (P = 0.08), while Stage II exhibited a significant difference (P < 0.001). Across the same treatment area, pressures for Stages I and II in the forearm were significantly lower than those in Stage III (P < 0.001). The treatment pressure differences between forearm stages I and II were not statistically significant (P > 0.05). Differences in upper arm treatment pressures across Stages I, II, and III were also statistically significant (P < 0.001).
Discussion: The study provides quantitative evidence on the pressure ranges needed for MLD across different stages of BCRL. It highlights the importance for stage-specific pressure adjustments to optimize treatment outcomes. These findings contribute to the existing body of knowledge on MLD and offer valuable data that could inform the development of rehabilitation technologies, including intelligent robots and visualization systems, as well as enhance therapist training programs.
{"title":"Quantitative analysis of pressure levels in manual lymphatic drainage across stages of breast cancer-related lymphedema: implications for optimized treatment protocols.","authors":"Naifang Xing, Daiqing Liu, Lufeng Chen, Guorong Wang, Yuan Tian, Chen Yang, Yingjie Leng, Xin Jiang, Chengxiang Li, Ruonan Xie, Zhuomiao Nie, Tian Zhang","doi":"10.1007/s10549-024-07540-2","DOIUrl":"https://doi.org/10.1007/s10549-024-07540-2","url":null,"abstract":"<p><strong>Objective: </strong>To quantify the pressure levels necessary for effective Manual Lymphatic Drainage (MLD) in managing Breast Cancer-Related Lymphedema (BCRL) across various stages, and to contribute to the development of standardized protocols for MLD therapy.</p><p><strong>Methods: </strong>The study included 42 patients with BCRL (Stages I-III) and 14 certified lymphedema therapists. Forearms and upper arm circumferences were measured pre and post a 21-day MLD intervention. A tactile sensor system recorded the applied pressure during treatment. The data were preprocessed and statistically analyzed to assess pressure patterns and their stage-specific impacts on lymphedema.</p><p><strong>Results: </strong>The mean age of the patients was 52.4 years, and that of the therapists was 39.1 years. A statistically significant reduction in arm circumference was observed post-MLD treatment (P < 0.05). The pressure applied varied across stages: I <sub>forearm</sub> 16.5-20.1 mmHg, I <sub>upper arm</sub> 16.1-20.7 mmHg; II <sub>forearm</sub> 16.6-19.8 mmHg, II <sub>upper arm</sub> 19.7-23.8 mmHg; III <sub>forearm</sub> 29.3-34.3 mmHg, III <sub>upper arm</sub> 29.7-34.3 mmHg. No statistically significant difference was found between forearm and upper arm treatment pressures within Stages I (P = 0.283) and III (P = 0.08), while Stage II exhibited a significant difference (P < 0.001). Across the same treatment area, pressures for Stages I and II in the forearm were significantly lower than those in Stage III (P < 0.001). The treatment pressure differences between forearm stages I and II were not statistically significant (P > 0.05). Differences in upper arm treatment pressures across Stages I, II, and III were also statistically significant (P < 0.001).</p><p><strong>Discussion: </strong>The study provides quantitative evidence on the pressure ranges needed for MLD across different stages of BCRL. It highlights the importance for stage-specific pressure adjustments to optimize treatment outcomes. These findings contribute to the existing body of knowledge on MLD and offer valuable data that could inform the development of rehabilitation technologies, including intelligent robots and visualization systems, as well as enhance therapist training programs.</p>","PeriodicalId":9133,"journal":{"name":"Breast Cancer Research and Treatment","volume":null,"pages":null},"PeriodicalIF":3.0,"publicationDate":"2024-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142567071","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Purpose: To generate a model for predicting nodal response to neoadjuvant systemic treatment (NAST) in biopsy-proven node-positive breast cancer patients (cN+) that incorporates tumor microenvironment (TME) characteristics and could be used for planning the axillary surgical staging procedure.
Methods: Clinical and pathologic features were retrospectively collected for 437 patients. Core biopsy (CB) samples were reviewed for stromal content and tumor-infiltrating lymphocytes (TIL). Orange Datamining Toolbox was used for model generation and assessment.
Results: 151/437 (34.6%) patients achieved nodal pCR (ypN0). The following 5 variables were included in the prediction model: ER, Her-2, grade, stroma content and TILs. After stratified tenfold cross-validation, the logistic regression algorithm achieved and area under the ROC curve (AUC) of 0.86 and F1 score of 0.72. Nomogram was used for visualization.
Conclusions: We developed a clinical tool to predict nodal pCR for cN+ patients after NAST that includes biomarkers of TME and achieves an AUC of 0.86 after tenfold cross-validation.
{"title":"Predicting nodal response to neoadjuvant treatment in breast cancer with core biopsy biomarkers of tumor microenvironment using data mining.","authors":"Nina Pislar, Gorana Gasljevic, Erika Matos, Gasper Pilko, Janez Zgajnar, Andraz Perhavec","doi":"10.1007/s10549-024-07539-9","DOIUrl":"https://doi.org/10.1007/s10549-024-07539-9","url":null,"abstract":"<p><strong>Purpose: </strong>To generate a model for predicting nodal response to neoadjuvant systemic treatment (NAST) in biopsy-proven node-positive breast cancer patients (cN+) that incorporates tumor microenvironment (TME) characteristics and could be used for planning the axillary surgical staging procedure.</p><p><strong>Methods: </strong>Clinical and pathologic features were retrospectively collected for 437 patients. Core biopsy (CB) samples were reviewed for stromal content and tumor-infiltrating lymphocytes (TIL). Orange Datamining Toolbox was used for model generation and assessment.</p><p><strong>Results: </strong>151/437 (34.6%) patients achieved nodal pCR (ypN0). The following 5 variables were included in the prediction model: ER, Her-2, grade, stroma content and TILs. After stratified tenfold cross-validation, the logistic regression algorithm achieved and area under the ROC curve (AUC) of 0.86 and F1 score of 0.72. Nomogram was used for visualization.</p><p><strong>Conclusions: </strong>We developed a clinical tool to predict nodal pCR for cN+ patients after NAST that includes biomarkers of TME and achieves an AUC of 0.86 after tenfold cross-validation.</p>","PeriodicalId":9133,"journal":{"name":"Breast Cancer Research and Treatment","volume":null,"pages":null},"PeriodicalIF":3.0,"publicationDate":"2024-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142575177","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Purpose: Adolescent and young adult (AYA) patients with breast cancer generally have poor prognoses and a higher risk of secondary cancers compared to those at the same cancer stage. Notably, AYA patients in Asia exhibit a higher incidence rate of breast cancer, with Luminal A as the predominant molecular subtype, which contrasts with the trends observed in Western countries. This study aims to compare the efficacy of Taxane/Anthracycline combination-based regimens (TACB) versus Anthracycline-based regimens (AB) in AYA patients with stage I-II breast cancer, focusing on different molecular subtypes.
Methods: This study utilized data from the Taiwan National Health Insurance Research Database (NHIRD) and the Taiwan Cancer Registry (TCR) from 2011 to 2019. The study cohort included patients aged 15 to 39 years who were diagnosed with stage I-II breast cancer and received either TACB or AB regimens. Propensity score matching and Cox proportional hazards regression models were used to calculate the hazard ratios (HR) for recurrence.
Results: The results showed that TACB regimens significantly reduced the risk of recurrence compared to AB regimens across all patients (aHR 0.73, 95% CI 0.55-0.97). Specifically, for low/middle-recurrence risk groups, the aHR was 0.68 (95% CI 0.49-0.96), and for high-recurrence risk groups, it was 0.43 (95% CI 0.21-0.87). The analysis further indicated no significant differences in recurrence risk between AYA and non-AYA patients using TACB regimens.
Conclusion: The TACB regimens showed a more favorable prognosis than AB regimens across all molecular subtypes. Furthermore, TACB regimens not only outperformed AB treatments but also closed the gap in prognostic outcomes between AYA and non-AYA patients. We believe the findings of this study are highly reliable and can provide valuable guidance for physicians in choosing the most appropriate treatment strategies for AYA patients with stage I-II breast cancer.
目的:与处于同一癌症阶段的患者相比,青少年乳腺癌患者的预后一般较差,且继发癌症的风险较高。值得注意的是,亚洲的青少年和青年乳腺癌患者发病率较高,主要分子亚型为Luminal A,这与西方国家观察到的趋势形成鲜明对比。本研究旨在比较以紫杉类/金霉素联合疗法(TACB)为基础的治疗方案与以蒽环类药物为基础的治疗方案(AB)对 I-II 期乳腺癌亚亚裔患者的疗效,重点关注不同的分子亚型:本研究利用了台湾国民健康保险研究数据库(NHIRD)和台湾癌症登记中心(TCR)2011 年至 2019 年的数据。研究队列包括 15 至 39 岁确诊为 I-II 期乳腺癌并接受 TACB 或 AB 方案治疗的患者。研究采用倾向评分匹配和考克斯比例危险回归模型计算复发危险比(HR):结果表明,与 AB 方案相比,TACB 方案能显著降低所有患者的复发风险(aHR 0.73,95% CI 0.55-0.97)。具体而言,低/中复发风险组的 aHR 为 0.68(95% CI 0.49-0.96),高复发风险组为 0.43(95% CI 0.21-0.87)。分析进一步表明,使用TACB疗法的AYA和非AYA患者的复发风险没有明显差异:结论:在所有分子亚型中,TACB 方案的预后均优于 AB 方案。此外,TACB疗法不仅优于AB疗法,还缩小了AYA和非AYA患者在预后结果上的差距。我们相信这项研究的结果非常可靠,能为医生选择最适合 I-II 期乳腺癌 AYA 患者的治疗策略提供有价值的指导。
{"title":"Taxane/anthracycline combinations reduced incidence of breast cancer recurrence in young women across molecular subtypes: a real-world evidence of Taiwan from 2011 to 2019.","authors":"Yu-Ning Chien, Li-Yin Lin, Yi-Chun Lin, Yi-Chen Hsieh, Shih-Hsin Tu, Hung-Yi Chiou","doi":"10.1007/s10549-024-07527-z","DOIUrl":"https://doi.org/10.1007/s10549-024-07527-z","url":null,"abstract":"<p><strong>Purpose: </strong>Adolescent and young adult (AYA) patients with breast cancer generally have poor prognoses and a higher risk of secondary cancers compared to those at the same cancer stage. Notably, AYA patients in Asia exhibit a higher incidence rate of breast cancer, with Luminal A as the predominant molecular subtype, which contrasts with the trends observed in Western countries. This study aims to compare the efficacy of Taxane/Anthracycline combination-based regimens (TACB) versus Anthracycline-based regimens (AB) in AYA patients with stage I-II breast cancer, focusing on different molecular subtypes.</p><p><strong>Methods: </strong>This study utilized data from the Taiwan National Health Insurance Research Database (NHIRD) and the Taiwan Cancer Registry (TCR) from 2011 to 2019. The study cohort included patients aged 15 to 39 years who were diagnosed with stage I-II breast cancer and received either TACB or AB regimens. Propensity score matching and Cox proportional hazards regression models were used to calculate the hazard ratios (HR) for recurrence.</p><p><strong>Results: </strong>The results showed that TACB regimens significantly reduced the risk of recurrence compared to AB regimens across all patients (aHR 0.73, 95% CI 0.55-0.97). Specifically, for low/middle-recurrence risk groups, the aHR was 0.68 (95% CI 0.49-0.96), and for high-recurrence risk groups, it was 0.43 (95% CI 0.21-0.87). The analysis further indicated no significant differences in recurrence risk between AYA and non-AYA patients using TACB regimens.</p><p><strong>Conclusion: </strong>The TACB regimens showed a more favorable prognosis than AB regimens across all molecular subtypes. Furthermore, TACB regimens not only outperformed AB treatments but also closed the gap in prognostic outcomes between AYA and non-AYA patients. We believe the findings of this study are highly reliable and can provide valuable guidance for physicians in choosing the most appropriate treatment strategies for AYA patients with stage I-II breast cancer.</p>","PeriodicalId":9133,"journal":{"name":"Breast Cancer Research and Treatment","volume":null,"pages":null},"PeriodicalIF":3.0,"publicationDate":"2024-11-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142563743","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-11-01Epub Date: 2024-06-28DOI: 10.1007/s10549-024-07411-w
Senna W M Lammers, Sandra M E Geurts, Karlijn E P E Hermans, Irene E G van Hellemond, Astrid C P Swinkels, Carolien H Smorenburg, Maurice J C van der Sangen, Judith R Kroep, Aafke H Honkoop, Franchette W P J van den Berkmortel, Wilfred K de Roos, Alexander L T Imholz, Ingeborg J H Vriens, Vivianne C G Tjan-Heijnen
Purpose: Patients with chemotherapy-induced ovarian function failure (CIOFF) may experience ovarian function recovery (OFR). Earlier, we showed that OFR during treatment with anastrozole impacted the prognosis of hormone receptor-positive (HR+) breast cancer (BC) patients with CIOFF. Here, we present the long-term follow-up results.
Methods: Postmenopausal women with HR+ BC who were 45-57 years of age and received chemotherapy were identified from the phase 3 DATA study (NCT00301457) on the extended use of anastrozole. Eligible patients were categorised into two groups: patients with CIOFF and definitely postmenopausal patients. Patients with CIOFF were monitored for OFR. Disease-free survival (DFS), distant recurrence-free survival (DRFS), and overall survival (OS) were compared between patients with OFR and patients without OFR using multivariable Cox regression analyses, including OFR as a time-dependent covariate. BC-specific mortality (BCSM) was compared between groups using the Fine and Gray method.
Results: This study included 656 patients: 395 patients with CIOFF and 261 definitely postmenopausal patients. OFR occurred in 39 (12%) of 329 patients with CIOFF who were monitored for OFR. The median follow-up time was 13.3 years. Patients with OFR experienced a deterioration in DFS (hazard ratio (HR) = 1.54; 95% confidence interval (CI) 0.85-2.81), DRFS (HR = 1.51; 95% CI 0.73-3.11), OS (HR = 1.64; 95% CI 0.75-3.55), and BCSM (subdistribution HR = 1.98; 95% CI 0.84-4.63) when compared with patients without OFR.
Conclusion: In patients with CIOFF, OFR during treatment with anastrozole was associated with a deterioration in BC outcomes. These findings underscore the importance of adequate ovarian function suppression in this subgroup of patients.
{"title":"Ovarian function recovery in breast cancer patients receiving adjuvant anastrozole treatment: updated results from the phase 3 DATA trial.","authors":"Senna W M Lammers, Sandra M E Geurts, Karlijn E P E Hermans, Irene E G van Hellemond, Astrid C P Swinkels, Carolien H Smorenburg, Maurice J C van der Sangen, Judith R Kroep, Aafke H Honkoop, Franchette W P J van den Berkmortel, Wilfred K de Roos, Alexander L T Imholz, Ingeborg J H Vriens, Vivianne C G Tjan-Heijnen","doi":"10.1007/s10549-024-07411-w","DOIUrl":"10.1007/s10549-024-07411-w","url":null,"abstract":"<p><strong>Purpose: </strong>Patients with chemotherapy-induced ovarian function failure (CIOFF) may experience ovarian function recovery (OFR). Earlier, we showed that OFR during treatment with anastrozole impacted the prognosis of hormone receptor-positive (HR+) breast cancer (BC) patients with CIOFF. Here, we present the long-term follow-up results.</p><p><strong>Methods: </strong>Postmenopausal women with HR+ BC who were 45-57 years of age and received chemotherapy were identified from the phase 3 DATA study (NCT00301457) on the extended use of anastrozole. Eligible patients were categorised into two groups: patients with CIOFF and definitely postmenopausal patients. Patients with CIOFF were monitored for OFR. Disease-free survival (DFS), distant recurrence-free survival (DRFS), and overall survival (OS) were compared between patients with OFR and patients without OFR using multivariable Cox regression analyses, including OFR as a time-dependent covariate. BC-specific mortality (BCSM) was compared between groups using the Fine and Gray method.</p><p><strong>Results: </strong>This study included 656 patients: 395 patients with CIOFF and 261 definitely postmenopausal patients. OFR occurred in 39 (12%) of 329 patients with CIOFF who were monitored for OFR. The median follow-up time was 13.3 years. Patients with OFR experienced a deterioration in DFS (hazard ratio (HR) = 1.54; 95% confidence interval (CI) 0.85-2.81), DRFS (HR = 1.51; 95% CI 0.73-3.11), OS (HR = 1.64; 95% CI 0.75-3.55), and BCSM (subdistribution HR = 1.98; 95% CI 0.84-4.63) when compared with patients without OFR.</p><p><strong>Conclusion: </strong>In patients with CIOFF, OFR during treatment with anastrozole was associated with a deterioration in BC outcomes. These findings underscore the importance of adequate ovarian function suppression in this subgroup of patients.</p>","PeriodicalId":9133,"journal":{"name":"Breast Cancer Research and Treatment","volume":null,"pages":null},"PeriodicalIF":3.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11452455/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141466184","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}
Pub Date : 2024-11-01Epub Date: 2024-06-25DOI: 10.1007/s10549-024-07393-9
Mahmoud A Seliem, Ahmed M Mohamadin, Mohamed I Kotb El-Sayed, Yahia Ismail, Ahmed A El-Husseiny
Purpose: Macrophage migration inhibitory factor (MIF) is an integral cytokine for the modulation of both innate and adaptive immunity and is involved in the pathogenesis of various cancers. However, conflicting findings on the relationship between MIF polymorphisms and breast cancer (BC) have been reported in earlier research. We investigated the clinical value of serum MIF levels and the association between MIF rs1049829 and rs755622 variants with their serum levels and propensity to develop BC.
Methods: A total of 133 treatment-naïve Egyptian BC females and 126 apparently healthy controls were matriculated in this case-control study. The serum MIF protein levels were quantified by ELISA, whereas the genotyping was executed utilizing the TaqMan® allelic discrimination assay.
Results: A significant increase in the serum MIF level in BC cases was observed in comparison to control subjects (P < 0.0001), with a diagnostic potential to discriminate BC with 92.5% sensitivity and 73.7% specificity at a cut-off value > 9.47 ng/mL. Besides, a significant difference in serum MIF level was observed in BC cases with progesterone receptor (PR) negativity compared to those with PR positivity (P = 0.046). Moreover, a significant association was depicted between the rs1049829 variant of MIF gene and the protective effect against BC meanwhile the rs755622 variant demonstrated no significant link with BC risk.
Conclusions: This study revealed that serum MIF levels may be regarded as a promising serum tumor marker for BC. Also, the rs1049829 variant of the MIF gene is considered a protective candidate against BC.
目的:巨噬细胞迁移抑制因子(MIF)是调节先天性免疫和适应性免疫不可或缺的细胞因子,并参与多种癌症的发病机制。然而,关于 MIF 多态性与乳腺癌(BC)之间关系的研究结果却相互矛盾。我们研究了血清MIF水平的临床价值,以及MIF rs1049829和rs755622变异与其血清水平和乳腺癌发病倾向之间的关系:这项病例对照研究共纳入了133名未经治疗的埃及BC女性和126名表面健康的对照者。血清 MIF 蛋白水平通过酶联免疫吸附法(ELISA)进行定量,基因分型则通过 TaqMan® 等位基因鉴别检测法进行:结果:与对照组相比,BC 病例的血清 MIF 水平明显升高(P 9.47 ng/mL)。此外,与孕酮受体(PR)阴性的 BC 病例相比,孕酮受体阳性的 BC 病例的血清 MIF 水平有明显差异(P = 0.046)。此外,MIF基因的rs1049829变异与对BC的保护作用有明显关联,而rs755622变异与BC风险无明显联系:结论:本研究表明,血清 MIF 水平可作为 BC 的血清肿瘤标志物。结论:这项研究表明,血清 MIF 水平可被视为 BC 潜在的血清肿瘤标志物,而且 MIF 基因的 rs1049829 变体被认为是 BC 的保护性候选基因。
{"title":"The clinical signature of genetic variants and serum levels of macrophage migration inhibitory factor in Egyptian breast cancer patients.","authors":"Mahmoud A Seliem, Ahmed M Mohamadin, Mohamed I Kotb El-Sayed, Yahia Ismail, Ahmed A El-Husseiny","doi":"10.1007/s10549-024-07393-9","DOIUrl":"10.1007/s10549-024-07393-9","url":null,"abstract":"<p><strong>Purpose: </strong>Macrophage migration inhibitory factor (MIF) is an integral cytokine for the modulation of both innate and adaptive immunity and is involved in the pathogenesis of various cancers. However, conflicting findings on the relationship between MIF polymorphisms and breast cancer (BC) have been reported in earlier research. We investigated the clinical value of serum MIF levels and the association between MIF rs1049829 and rs755622 variants with their serum levels and propensity to develop BC.</p><p><strong>Methods: </strong>A total of 133 treatment-naïve Egyptian BC females and 126 apparently healthy controls were matriculated in this case-control study. The serum MIF protein levels were quantified by ELISA, whereas the genotyping was executed utilizing the TaqMan® allelic discrimination assay.</p><p><strong>Results: </strong>A significant increase in the serum MIF level in BC cases was observed in comparison to control subjects (P < 0.0001), with a diagnostic potential to discriminate BC with 92.5% sensitivity and 73.7% specificity at a cut-off value > 9.47 ng/mL. Besides, a significant difference in serum MIF level was observed in BC cases with progesterone receptor (PR) negativity compared to those with PR positivity (P = 0.046). Moreover, a significant association was depicted between the rs1049829 variant of MIF gene and the protective effect against BC meanwhile the rs755622 variant demonstrated no significant link with BC risk.</p><p><strong>Conclusions: </strong>This study revealed that serum MIF levels may be regarded as a promising serum tumor marker for BC. Also, the rs1049829 variant of the MIF gene is considered a protective candidate against BC.</p>","PeriodicalId":9133,"journal":{"name":"Breast Cancer Research and Treatment","volume":null,"pages":null},"PeriodicalIF":3.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11452551/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141445108","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}
Pub Date : 2024-11-01Epub Date: 2024-06-20DOI: 10.1007/s10549-024-07409-4
Song Wen, Meng Zhang, Jiuan Chen, Li Hu, Jie Sun, Lu Yao, Ye Xu, Juan Zhang, Yuntao Xie
Purpose: Despite of very rare, breast cancer patients with double heterozygosity (DH) variants in BRCA1 and BRCA2 genes have been identified in other ethnic groups and seem to be associated with distinctive phenotypes. However, little is known about the frequency and clinical characteristics of Chinese breast cancer patients with BRCA1/2 DH variants.
Methods: Four hundred and eleven unrelated patients with BRCA1 or BRCA2 pathogenic variants (PVs) were identified in a large series of unselected breast cancer patients. Another two siblings with metachronous bilateral breast cancer were referred for genetic counseling, after which BRCA1/2 DH variants were detected.
Results: Four unrelated breast cancer patients with BRCA1/2 DH were identified in the cohort of 411 patients with BRCA1 or BRCA2 PVs, the frequency of BRCA1/2 DH was 0.97%. In total, six BRCA1/2 DH patients from five families were found in this study. In two families, the hereditary pattern of DH was speculated to have originated from both sides of the family. BRCA1/2 DH patients were more likely to have a family history of breast cancer than patients with a BRCA1 (100% vs. 29.2%, P = 0.004) or BRCA2 (100% vs. 29.6%, P = 0.004) single PV. BRCA1/2 DH patients were more likely to be triple-negative breast tumors than patients with single BRCA2 PVs (66.7% vs. 14.1%, P = 0.020), which was comparable to the findings in patients with single BRCA1 PVs (66.7% vs. 56.9%, P = 1.00).
Conclusion: Chinese patients with BRCA1/2 DH exhibit a high percentage of family history of breast cancer. The tumor pathological features of BRCA1/2 DH carriers are similar to those of BRCA1 PV carriers.
{"title":"Characteristics of Chinese breast cancer patients with double heterozygosity for BRCA1 and BRCA2 germline pathogenic variants.","authors":"Song Wen, Meng Zhang, Jiuan Chen, Li Hu, Jie Sun, Lu Yao, Ye Xu, Juan Zhang, Yuntao Xie","doi":"10.1007/s10549-024-07409-4","DOIUrl":"10.1007/s10549-024-07409-4","url":null,"abstract":"<p><strong>Purpose: </strong>Despite of very rare, breast cancer patients with double heterozygosity (DH) variants in BRCA1 and BRCA2 genes have been identified in other ethnic groups and seem to be associated with distinctive phenotypes. However, little is known about the frequency and clinical characteristics of Chinese breast cancer patients with BRCA1/2 DH variants.</p><p><strong>Methods: </strong>Four hundred and eleven unrelated patients with BRCA1 or BRCA2 pathogenic variants (PVs) were identified in a large series of unselected breast cancer patients. Another two siblings with metachronous bilateral breast cancer were referred for genetic counseling, after which BRCA1/2 DH variants were detected.</p><p><strong>Results: </strong>Four unrelated breast cancer patients with BRCA1/2 DH were identified in the cohort of 411 patients with BRCA1 or BRCA2 PVs, the frequency of BRCA1/2 DH was 0.97%. In total, six BRCA1/2 DH patients from five families were found in this study. In two families, the hereditary pattern of DH was speculated to have originated from both sides of the family. BRCA1/2 DH patients were more likely to have a family history of breast cancer than patients with a BRCA1 (100% vs. 29.2%, P = 0.004) or BRCA2 (100% vs. 29.6%, P = 0.004) single PV. BRCA1/2 DH patients were more likely to be triple-negative breast tumors than patients with single BRCA2 PVs (66.7% vs. 14.1%, P = 0.020), which was comparable to the findings in patients with single BRCA1 PVs (66.7% vs. 56.9%, P = 1.00).</p><p><strong>Conclusion: </strong>Chinese patients with BRCA1/2 DH exhibit a high percentage of family history of breast cancer. The tumor pathological features of BRCA1/2 DH carriers are similar to those of BRCA1 PV carriers.</p>","PeriodicalId":9133,"journal":{"name":"Breast Cancer Research and Treatment","volume":null,"pages":null},"PeriodicalIF":3.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141426355","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-11-01Epub Date: 2024-08-24DOI: 10.1007/s10549-024-07466-9
Camila Vitola Pasetto, Fernando Nalesso Aguiar, Marcella Bassan Peixoto, Maíra Teixeira Dória, Bruna Salani Mota, Jonathan Yugo Maesaka, José Roberto Filassi, Edmund Chada Baracat, Rodrigo Gonçalves
Purpose: To assess the association between tumor-infiltrating lymphocytes (TILs) in ductal carcinoma in situ (DCIS) samples and disease recurrence.
Methods: This retrospective cohort study included women aged 18 years and older who underwent treatment between January 2007 and December 2020. Male patients, individuals diagnosed with invasive or microinvasive disease based on anatomopathological examination of surgical specimens, and those with a personal history of any other cancers were excluded. Additionally, the presence of "touching TILs" (lymphocytes in direct contact with tumor cells) and periductal desmoplasia were evaluated as complementary methods to represent the immunological microenvironment. The primary outcome was relapse-free survival based on TIL quantification adjusted for potential confounders. Pathologists assessed TILs in the sample with the highest tumor representation and quantified them as a percentage. Survival was evaluated using Kaplan‒Meier curves, log-rank tests, and Cox regression models.
Results: A total of 191 patients met the eligibility criteria. The mean follow-up duration was 77.2 months, with a recurrence rate of 9.2%. Patients with TILs ≥ 17% had a greater risk of recurrence (HR 2.97, 95% CI 1.17-7.51; p = 0.02). Additionally, focal necrosis (HR 6.4, 95% CI 1.39-34.71; p = 0.018) or comedonecrosis (HR 4.53, 95% CI 1.34-15.28; p = 0.015) were associated with increased recurrence risk. According to the multivariate model, comedonecrosis and TILs ≥ 17% were significantly associated with recurrence (p = 0.034 and p = 0.035, respectively). Regarding the evaluations of "touching TILs" and periductal desmoplasia, no statistical significance was found when assessing their association with disease recurrence.
Conclusion: In our cohort, a high percentage of TILs (≥ 17%) and the presence of comedonecrosis were independently associated with DCIS recurrence.
目的:评估导管原位癌(DCIS)样本中肿瘤浸润淋巴细胞(TILs)与疾病复发之间的关系:这项回顾性队列研究纳入了 2007 年 1 月至 2020 年 12 月期间接受治疗的 18 岁及以上女性。男性患者、根据手术标本的解剖病理学检查被诊断为浸润性或微小浸润性疾病的患者以及有其他癌症病史的患者均被排除在外。此外,还评估了 "接触性TIL"(与肿瘤细胞直接接触的淋巴细胞)和导管周围脱钙化的存在情况,作为代表免疫微环境的补充方法。主要结果是基于TIL定量的无复发生存期,并对潜在的混杂因素进行了调整。病理学家对肿瘤代表性最高的样本中的TIL进行评估,并将其量化为一个百分比。采用卡普兰-梅耶曲线、对数秩检验和考克斯回归模型对生存率进行评估:共有 191 名患者符合资格标准。平均随访时间为 77.2 个月,复发率为 9.2%。TIL≥17%的患者复发风险更高(HR 2.97,95% CI 1.17-7.51;P = 0.02)。此外,局灶性坏死(HR 6.4,95% CI 1.39-34.71;P = 0.018)或彗星状坏死(HR 4.53,95% CI 1.34-15.28;P = 0.015)与复发风险增加有关。根据多变量模型,合并颌骨坏死和 TIL ≥ 17% 与复发显著相关(分别为 p = 0.034 和 p = 0.035)。关于 "触及TILs "和导管周围脱钙化的评估,在评估其与疾病复发的相关性时未发现统计学意义:结论:在我们的队列中,高比例的TILs(≥ 17%)和存在粉瘤与DCIS复发独立相关。
{"title":"Evaluation of tumor infiltrating lymphocytes as a prognostic biomarker in patients with ductal carcinoma in situ of the breast.","authors":"Camila Vitola Pasetto, Fernando Nalesso Aguiar, Marcella Bassan Peixoto, Maíra Teixeira Dória, Bruna Salani Mota, Jonathan Yugo Maesaka, José Roberto Filassi, Edmund Chada Baracat, Rodrigo Gonçalves","doi":"10.1007/s10549-024-07466-9","DOIUrl":"10.1007/s10549-024-07466-9","url":null,"abstract":"<p><strong>Purpose: </strong>To assess the association between tumor-infiltrating lymphocytes (TILs) in ductal carcinoma in situ (DCIS) samples and disease recurrence.</p><p><strong>Methods: </strong>This retrospective cohort study included women aged 18 years and older who underwent treatment between January 2007 and December 2020. Male patients, individuals diagnosed with invasive or microinvasive disease based on anatomopathological examination of surgical specimens, and those with a personal history of any other cancers were excluded. Additionally, the presence of \"touching TILs\" (lymphocytes in direct contact with tumor cells) and periductal desmoplasia were evaluated as complementary methods to represent the immunological microenvironment. The primary outcome was relapse-free survival based on TIL quantification adjusted for potential confounders. Pathologists assessed TILs in the sample with the highest tumor representation and quantified them as a percentage. Survival was evaluated using Kaplan‒Meier curves, log-rank tests, and Cox regression models.</p><p><strong>Results: </strong>A total of 191 patients met the eligibility criteria. The mean follow-up duration was 77.2 months, with a recurrence rate of 9.2%. Patients with TILs ≥ 17% had a greater risk of recurrence (HR 2.97, 95% CI 1.17-7.51; p = 0.02). Additionally, focal necrosis (HR 6.4, 95% CI 1.39-34.71; p = 0.018) or comedonecrosis (HR 4.53, 95% CI 1.34-15.28; p = 0.015) were associated with increased recurrence risk. According to the multivariate model, comedonecrosis and TILs ≥ 17% were significantly associated with recurrence (p = 0.034 and p = 0.035, respectively). Regarding the evaluations of \"touching TILs\" and periductal desmoplasia, no statistical significance was found when assessing their association with disease recurrence.</p><p><strong>Conclusion: </strong>In our cohort, a high percentage of TILs (≥ 17%) and the presence of comedonecrosis were independently associated with DCIS recurrence.</p>","PeriodicalId":9133,"journal":{"name":"Breast Cancer Research and Treatment","volume":null,"pages":null},"PeriodicalIF":3.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142046345","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}