European journal of breast health最新文献

Objective: Breast cancer is the most common cancer and the leading cause of cancer-related deaths in women. Texture analysis provides crucial prognostic information about many types of cancer, including breast cancer. The aim was to examine the relationship between texture features (TFs) of 2-deoxy-2[¹⁸F] fluoro-D-glucose positron emission tomography (PET)/computed tomography and disease progression in patients with invasive breast cancer.

Materials and methods: TFs of the primary malignant lesion were extracted from PET images of 112 patients. TFs that showed significant differences between patients who achieved one-, three-, and five-year progression-free survival (PFS) and those who did not were selected and subjected to the least absolute shrinkage and selection operator regression method to reduce features and prevent overfitting. Machine learning (ML) was used to predict PFS using TFs and selected clinicopathological parameters.

Results: In models using only TFs, random forest predicted one-, three-, and five-year PFS with area under the curve (AUC) values of 0.730, 0.758, and 0.797, respectively. Naive Bayes predicted one-, three-, and five-year PFS with AUC values of 0.857, 0.804, and 0.843, respectively. The neural network predicted one-, three-, and five-year PFS with AUC values of 0.782, 0.828, and 0.780, respectively. These findings indicated increased AUC values when the models combined TFs with clinicopathological parameters. The lowest AUC values of the models combining TFs and clinicopathological parameters when predicting one-year, three-year, and five-year PFS were 0.867, 0.898, and 0.867, respectively.

Conclusion: ML models incorporating PET-derived TFs and clinical parameters may assist in predicting progression during the pre-treatment period in patients with invasive breast carcinoma.

Objective: High mobility group box 1 (HMGB1) is a nonhistone chromatin-associated protein involved in chromatin remodeling, transcription, DNA replication, and repair. The purpose of this study was to assess the relationship between tissue expression of HMGB1, clinical outcomes, and histopathological characteristics in patients with breast cancer.

Materials and methods: The study included 282 patients with breast cancer. An in vitro diagnostic HMGB1 antibody was applied to the slides of tumor specimens.

Results: Overexpression of HMGB1 was found in tumor cells of 123 (43.6%) patients. HMGB1 was only expressed in the nucleus in most tumors (88.7%), while in 32 (11.3%) tumors HMBG1 expression was cytoplasmic and/or extracellular. Severe inflammatory infiltration of the peritumoral stroma was observed in 76 (27%) patients. There was a correlation between remarkable inflammatory cell infiltration in the tumor microenvironment and HMGB1 overexpression, regardless of the molecular subtype, as well as the extranuclear location of HMGB1 expression (p = 0.023). HMGB1 expression was not found to be associated with overall or disease-free survival. However, axillary lymph node metastasis was significantly more common in tumors with intense inflammation (p = 0.024).

Conclusion: The proportion of breast cancer patients with HMGB1 expression was lower in the present study than that reported previously. Furthermore, we did not detect a relationship between HMGB1 expression and prognosis. However, the relationship between HMGB1 expression and prognosis had been previously reported only in aggressive breast cancers. It is suggested that understanding the significance of HMGB1 expression in breast cancer may open new treatment opportunities, especially in aggressive and/or triple negative tumors.

Dermatofibrosarcoma protuberans (DFSP) is a rare, low-grade, fibroblastic mesenchymal tumor derived from the dermis. Breast is an uncommon site with an incidence of only 0.8-4.5% and an overall population incidence at any site of 4.2-4.5 per million. Surgical excision with 2-3 cm margin is the gold standard treatment. Selected cases are subjected to radiotherapy or systemic therapy with Imatinib. Due to the rare presentation, we report a similar case of DFSP on the left breast in a 42-year-old woman, who was initially diagnosed with benign phyllodes tumor of the left breast and final histopathology report of the wide local excision specimen diagnosed DFSP of the breast.

Objective: Mastectomy is a widely used surgical intervention for breast cancer in Pakistan, where late-stage diagnoses are common and breast-conserving options are often limited. While effective oncologically, mastectomy can significantly affect a woman's body image, emotional well-being, and social relationships. In Pakistan, sociocultural norms and limited reconstructive services further shape the post-mastectomy experience. This study aimed to assess self-perception, body image satisfaction, and related psychosocial impact in Pakistani women following mastectomy.

Materials and methods: This descriptive cross-sectional study was conducted at the breast oncology clinic of the Sindh Institute of Urology and Transplantation, Karachi. A total of 159 post-mastectomy patients aged 18-65 years were surveyed using a structured, culturally adapted questionnaire based on the body image scale. Statistical analyses included chi-square testing and multinomial logistic regression to assess associations between body image perception and demographic or psychosocial variables. Internal consistency was confirmed (Cronbach's alpha = 0.863).

Results: While 34% reported no change in body image perception, 66% reported varying degrees of change. Strong associations were identified between negative body image perception and feelings of reduced attractiveness, mirror discomfort, and spousal relationship changes (p<0.001). Multinomial regression confirmed these as significant predictors of reporting major body image change. Interest in breast reconstruction was low (15.7%), and although age and education were not significantly associated, time since surgery approached significance (p = 0.07).

Conclusion: A substantial proportion of Pakistani women experience emotional and psychosocial distress following mastectomy. These findings highlight the importance of early counseling, spousal support, and culturally sensitive body image discussions to promote long-term psychosocial recovery.

Objective: Sentinel lymph node biopsy (SLNB) is a key procedure for evaluating axillary lymph node status in early breast cancer, offering lower morbidity than axillary lymph node dissection. Intraoperative evaluation (IOE) of sentinel lymph nodes (SLNs) with methods like frozen section (FS) and imprint cytology (IC) aid in making immediate surgical decisions, although IOE accuracy may vary due to several factors.

Materials and methods: This retrospective study involved 2,528 patients with invasive breast cancer who underwent SLNB at a single institution from 2012 to 2024. Primarily, IC was used for intraoperative assessment, while FS was selectively performed in certain cases, such as with suspicious macroscopic findings or after neoadjuvant chemotherapy (NAC). The final diagnosis relied on permanent sections with serial step-leveling and classification of metastasis size.

Results: IOE showed a sensitivity of 65.8% and specificity of 97% for detecting lymph node metastases. The combination of IC and FS yielded higher sensitivity (76.1%) compared to IC alone (64.1%), particularly for isolated tumor cells (ITC). Patients treated with NAC exhibited slightly lower IOE accuracy (83.8%) compared to those without NAC (85.9%). False negatives were more common in cases of micrometastasis, ITC, and invasive lobular subtype. Excluding micrometastasis and ITC significantly enhanced IOE accuracy.

Conclusion: The accuracy of intraoperative SLN evaluation is affected by size of the metastasis, tumor subtype, and prior NAC. While IC is acceptable for IOE, combining IC and FS is advised, especially in the setting of earlier NAC, to enhance accuracy for small metastatic foci.

Objective: Hereditary hemochromatosis and breast cancer are two major public health problems. The HFE gene variants C282Y and H63D, responsible for most cases of hemochromatosis, may contribute to carcinogenesis via iron overload, oxidative stress, and hormonal modulation. The aim of this study was to evaluate the association between HFE variants and breast cancer risk and propose a personalized surveillance strategy.

Materials and methods: A systematic review and a meta-analysis were conducted according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Eligible studies included case-control and cohort studies reporting breast cancer incidence in women with HFE gene C282Y and/or H63D variants. Data were pooled using a random-effects model. Subgroup analyses and meta-regressions explored sources of heterogeneity.

Results: Eight studies comprising 73,981 participants were included, published between 2000 and 2025. Among them, analysis of four revealed a link between hemochromatosis and breast cancer risk. In one study, a link was observed between the HFE C282Y allele and higher lymph node involvement, which may suggest an impact of hemochromatosis on tumor progression. By contrast, three studies did not find any link between the two diseases. Our meta-analysis showed a trend toward increased breast cancer risk in carriers of HFE variants, particularly C282Y homozygotes (odds ratio = 1.36, 95% confidence interval = 0.75-1.98). Substantial heterogeneity was present (I² >50%), but no tested covariates significantly explained this variation. Sensitivity analyses confirmed the robustness of the estimate.

Conclusion: In the absence of randomized trials with mortality endpoints, our findings do not yet justify changes in clinical practice. They nevertheless support prospective studies to assess whether women carrying these pathogenic variants, especially C282Y/C282Y homozygotes, could benefit from adapted breast cancer surveillance, potentially involving more frequent evaluations or advanced imaging to improve early detection.

This is the first meta-analysis evaluating the benefit of adjuvant radiotherapy in older patients (≥65 years) with triple-negative breast cancer (TNBC). The medical literature was searched for all randomized controlled trials, nonrandomized controlled trials, and cohort studies with more than one treatment arm that evaluated radiation therapy for TNBC in patients aged >65 years. The primary outcome was overall survival. Four cohort studies (2015-2019) were eligible for analysis, including a total of 10,710 patients with TNBC of whom 7,209 underwent radiotherapy. Two were large retrospective population-based studies that yielded major findings on adjusted multivariable analysis. Patients who underwent radiotherapy (n = 6283/8526) had a significantly better 5-year overall survival than patients who did not (77% vs. 55%, p<0.001). The addition of radiotherapy (n = 815/1957) was associated with better cancer-specific survival. Of the two smaller studies, one prospective study reported similar survivability for treatment with breast-conserving surgery, chemotherapy, and radiotherapy or mastectomy with radiation, or mastectomy alone, and the other retrospective study found that adding radiotherapy had no effect on 5-year overall survival. Multivariate analyses of data from the two large retrospective population-based studies suggested that adding radiotherapy to breast-conserving surgery may improve overall and disease-free survival in elderly patients with TNBC.

Objective: The ropporin-1 (ROPN1) gene, initially linked to sperm motility, is differentially expressed in triple negative breast cancer (TNBC), suggesting a role in tumor progression and therapy resistance. To characterize ROPN1 expression in breast cancer and evaluate its association with clinicopathological features, survival, and treatment response as a translational biomarker.

Materials and methods: Data from The Cancer Genome Atlas (1,087 patients), Sweden Cancerome Analysis Network-Breast (3,273 patients), and geodatabases were analyzed. ROPN1 transcriptional levels were assessed in relation to clinical variables and survival. Chemotherapy agents and epigenetic modulators were tested in cell lines to evaluate ROPN1 regulation.

Results: Transcriptional overexpression of ROPN1 was significantly enriched in TNBC/basal-like tumors (p<0.0001) and correlated with reduced overall survival, particularly in basal cases [hazard ratio (HR) = 1.85; 95% confidence interval (CI): 1.02-3.33; p = 0.041]. Patients treated with chemotherapy and exhibiting high ROPN1 levels had unfavorable prognosis, with an even poorer profile in untreated cohorts (HR = 4.55; 95% CI: 1.33-14.29; p = 0.01). Hypomethylation at cg00101712 (HR = 0.59; p = 0.016) and cg09298623 (HR = 0.49; p = 0.0014) CpG sites were associated with worse survival at 5 years follow-up, underscoring epigenetic regulation of this pathway as a key driver of poor outcomes. Furthermore, in vitro treatment with cisplatin, doxorubicin, and paclitaxel resulted in variable responses, with a significant reduction of ROPN1 in HCC70 and HS578T cell lines, while BT549 and MDA-MB-231 cell lines showed notable increases.

Conclusion: ROPN1 overexpression in TNBC/basal-like tumors suggests a role as a prognostic biomarker and predictor of post-chemotherapy resistance. Investigation of ROPN1 expression in breast tumors may lead to alternative strategies targeting pro-metastatic pathways and improve precision treatment for aggressive breast cancer.

Objective: Cancer cells exhibit high metabolic demands and rely heavily on lipid metabolism for proliferation and membrane synthesis. Lipid transfer proteins, particularly the steroidogenic acute regulatory-related lipid transfer domain 3 (STARD3), play a significant role in intracellular cholesterol transport and may influence cancer progression. The aim of this study was to investigate serum STARD3 levels in patients with breast and prostate cancer and compare them with healthy controls, along with lipid parameters.

Materials and methods: Patients with breast cancer (women) and prostate cancer (men) were recruited together with a control group matched by age-range and sex. Serum samples were collected, and STARD3 levels were measured using a commercial ELISA kit. Lipid parameters and tumor markers (carbohydrate antigen 15-3, prostate-specific antigen) were also evaluated.

Results: A total of 200 individuals were enrolled: 50 female breast cancer patients, 50 male prostate cancer patients, and 100 healthy controls. STARD3 levels were significantly lower in both breast cancer (p = 0.045) and prostate cancer (p<0.001) groups compared to controls. However, no significant correlation was found between STARD3 levels and other biochemical parameters or tumor stage in either cancer group.

Conclusion: The results suggest that STARD3 may play a role in the pathogenesis of both hormone-related cancers, although the mechanism remains unclear. Given the limited studies evaluating STARD3 in both breast and prostate cancers simultaneously, our findings contribute novel data to the literature and may guide future research into the diagnostic or prognostic potential of STARD3 in oncology.