Breast Care最新文献

Background: The "International Consensus Conference for Advanced Breast Cancer" was initiated with the rationale to standardize treatment of advanced breast cancer (ABC) based on available evidence. The aim was to ensure that all ABC patients worldwide receive adequate treatment and get access to new diagnostic, therapeutic, and supportive options.

Topics of abc8: Since the beginning ABC Consensus Conference has been organized in Lisbon/Portugal. The 8th International Consensus Conference for ABC (ABC8) took place there from November 4th to 8th, 2025, and focused not only on metastatic disease but also on locally advanced and inflammatory breast cancer (BC). Special topics were new drugs and new therapies with promising results in randomized clinical trials. Not all of them are currently approved by FDA (Food and Drug Administration) or EMA (European Medicines Agency) for the indication in which the study was conducted. As in previous years, patient advocates from around the world were integrated into the ABC Conference and contributed substantially to the consensus.

Rationale for the manuscript: A German BC expert panel comments on the voting results of the ABC8 panelists regarding their relevance for routine clinical practice in Germany. As with previous meetings, the ABC8 votes focused on modified or new statements. Statements not modified for the ABC8 consensus remain valid. The German comments are always based on the current recommendations of the "Breast Committee" of the Gynecological Oncology Working Group (Arbeitsgemeinschaft Gynäkologische Onkologie, AGO Mamma).

Introduction: Chylous leakage is a rare complication following breast cancer surgery, characterized by milky, lipid-rich fluid collection in surgical drains. While well documented in thoracic and abdominal surgeries, its occurrence after breast procedures remains poorly understood with limited literature. This study evaluates the incidence, characteristics, and management of this complication.

Methods: A retrospective analysis was conducted, and seven patients with confirmed chyle leakage were identified among 1,441 breast cancer patients who underwent breast cancer surgery at two Hong Kong surgical centres within a 5-year period. Patients with prolonged drainage or milky fluid underwent laboratory analysis to confirm chylous leakage. Demographics, tumour characteristics, surgical details, management strategies, and outcomes were analysed.

Results: Seven patients (0.49%) developed chylous leakage. The median age was 67 years, and the median BMI was 22.2 kg/m². Four patients had right-sided, and three had left-sided breast cancer. Most tumours (85.7%) were located in the upper outer quadrant. All patients underwent mastectomy with various axillary procedures. Chylous drainage was identified between postoperative days 2 and 15 in 6 patients, with 1 late presentation at 6 months. Six patients (85.7%) were successfully managed with dietary modifications (medium-chain triglyceride or low-fat diet), with resolution within 3-11 days. One patient with late presentation required surgical intervention as definitive treatment. No recurrences or delays in adjuvant therapy occurred.

Conclusion: Chylous leakage after breast cancer surgery can occur on either side and can occur in patient with sentinel lymph node biopsy. Conservative management with dietary modification is highly effective as first-line treatment. This study highlights the need for increased awareness of this complication and provides foundation for further investigation into its incidence, pathophysiology, and optimal management.

[This corrects the article DOI: 10.1159/000548681.].

Introduction: In recent years, targeted therapeutic options for metastatic breast cancer (mBC) have improved significantly. In this analysis, we evaluated overall survival (OS) data of a prospectively documented cohort of 1,000 patients with mBC treated at the NCT Heidelberg from 2014 to 2022.

Patients and methods: Clinical data were prospectively collected and documented in the Prospective Academic Translational Research PRAEGNANT Network. OS was analyzed according to molecular subtype and line of therapy at study entry. We further evaluated the clinical characteristics associated with long-term (>5 years) and short-term (<1 year) survival.

Results: The median age at first diagnosis of metastasis was 57 years. A total of 132 patients (13%) presented with triple-negative, 189 (19%) with HER2 positive, and 609 (61%) with hormone receptor-positive, HER2-negative mBC. Median OS was 31.7 months. The longest median OS was observed in patients with HER2-positive and luminal A-like mBC (42 and 39 months, respectively). Patients with luminal B-like and triple-negative mBC showed significantly shorter OS (21 and 14 months, respectively). In univariable Cox regression analysis, significantly shorter OS was associated with higher tumor grade; negative estrogen receptor (ER), progesterone receptor (PR), and HER2 status; triple-negative molecular subtype; use of (neo)adjuvant chemotherapy; and later line of therapy at study entry. Multivariable Cox regression analysis revealed that higher tumor grade, negative ER and HER2 status, triple-negative or luminal B-like tumor biology, and study entry during later lines of therapy were the main risk factors for shorter OS. At 5-year follow-up, 17% of patients were still alive. Long-term survivors (>5 years) were more frequently ER, PR, and HER2 positive, received less often (neo)adjuvant chemotherapy, and had a longer disease-free interval.

Conclusion: This single-center, real-world analysis of 1,000 mBC patients revealed significant OS differences across molecular subtypes and provided valuable information on prognostic factors. These findings underscore the impact of tumor biology and the need for personalized treatment approaches.

Background: Breast-conserving therapy (BCT) combined with periareolar mastopexy aims to optimize oncological safety and aesthetic outcomes. One known complication is postoperative enlargement of the nipple-areola complex (NAC), which may affect patient satisfaction. This study investigates the frequency and extent of NAC changes following BCT and radiotherapy, using both conventional and three-dimensional imaging for objective measurement.

Methods: This retrospective single-center study included 50 women who underwent BCT with periareolar mastopexy and adjuvant radiotherapy between 2019 and 2023. Standardized postoperative assessments were performed ≥6 months after surgery and ≥4 months after radiotherapy. NAC diameters were measured using 3D surface imaging and conventional 2D photographs. Patient-reported satisfaction was assessed using the Breast-Q™ BCT module.

Results: A statistically significant enlargement of the NAC was observed on the operated side. Horizontal diameter increased by 4.4 mm (p < 0.001) and vertical diameter by 3.5 mm (p = 0.006) compared to the contralateral breast. Similar trends were confirmed in 2D images. Postoperative Breast-Q™ scores showed high satisfaction with the nipple (mean: 73 ± 23) and generally favorable ratings in psychosocial and physical well-being.

Conclusion: NAC enlargement is a measurable postoperative change following periareolar mastopexy in the context of BCT and radiotherapy. These findings highlight the relevance of realistic preoperative counseling and planning. While 3D imaging was used exclusively postoperatively, it offers a reproducible tool for outcome evaluation. Future studies should aim to include preoperative baseline data and prospective quality-of-life assessments.

Background: Breast papillary lesions are uncommon but clinically important due to their potential for histological upgrade. This study aimed to determine the factors that may influence histopathological upgrade in breast papillary lesions.

Methods: A retrospective review was conducted of female patients who underwent surgery for papillary lesions at Erciyes University Medical Faculty Hospital from 2010 onward. Upgrade was defined as a benign/low-risk lesion on biopsy found to be high risk or malignant after excision; downgrade referred to the opposite scenario. Statistical analyses were performed using SPSS 22.0 (chi-square test, p < 0.05). Associations were investigated between histopathological shift and variables including age, menopausal status, comorbidities, family history, palpable mass, symptom type, lesion laterality and quadrant, Breast Imaging Reporting and Data System (BI-RADS) category, microcalcification, breast density, echogenicity, lesion structure, contour, and biopsy method.

Results: Among 199 patients (median age: 53 years), 46 (23.1%) experienced histopathological upgrade and 13 (6.5%) had a downgrade. Upgrade was significantly associated with menopausal status (p = 0.029), hypertension (p = 0.014), lesion laterality (p = 0.028), and presence of a palpable mass (p = 0.045). Downgrade was significantly related to symptom type (p = 0.028) and presence of microcalcifications (p = 0.033). While BI-RADS category was significantly associated with upgrade (p = 0.035), it did not influence downgrade (p = 0.492). Lesion size, biopsy technique, breast density, echogenicity, lesion structure, and contour showed no significant effect on upgrade or downgrade outcomes (p > 0.05).

Conclusions: In breast papillary lesions, menopause, certain comorbidities, and specific radiological factors (such as BI-RADS category and calcifications) may increase the risk of histopathological transition. These findings underscore the importance of a multidisciplinary approach in diagnosing and managing intraductal papillomas. Larger scale studies could further refine risk stratification, potentially reducing unnecessary surgeries while facilitating earlier identification of high-risk patients.

Introduction: Breast cancer and mastitis significantly impact women's health and their infants' wellbeing. The advent of metagenomic sequencing technology has opened new avenues to explore the relationships between mammary microbiomes and these diseases. Despite recent extensive studies, detailed understanding of the mammary microbiome-disease relationships remains incomplete.

Methods and results: Here, we apply the Specificity and Specificity Diversity framework (Ma 2024, BMC Biology) to identify unique/enriched species (US/ES) associated with mastitis, breast cancer, or their healthy controls. The US/ES lists contain potential biomarkers and offer fresh insights into the intricacies of mastitis etiology and the relationship between breast tissue microbiomes and breast cancer.

Conclusions: (i) The dynamic balance between coexisting alliances of beneficial microbes and harmful microbes (including opportunistic pathogens) holds key to understanding mastitis etiology. (ii) Intra-tumor microbes may serve multiple roles - as oncogenic microbes, neutral bystanders, or tumor suppressors, and their dynamic balance can influence breast cancer onset and progression. (iii) Significant challenges remain in developing effective probiotics, prebiotics and infant formulas due to complex entanglements between beneficial and harmful microbes. This complexity suggests that broad-spectrum or one-size-fits-all probiotic approaches may prove inadequate, pointing instead to the need for personalized prebiotic/probiotic/infant-formula solutions to restore and maintain healthy mammary microbiomes.