Clinical Breast Cancer

Real-World Evidence on Prescribing Patterns and Clinical Outcomes of Metastatic Breast Cancer Patients Treated with PARP Inhibitors: The Mayo Clinic Experience
Jahan N, Taraba J, Boddicker NJ, Giridhar KV, Leon-Ferre RA, Tevaarwerk AJ, Cathcart-Rake E, O'Sullivan CC, Peethambaram PP, Hobday TJ, Mina LA, Batalini F, Advani P, Sideras K, Haddad TC, Ruddy KJ, Goetz MP, Couch FJ and Yadav S
This study evaluates real-world outcomes, toxicities, and prescribing patterns of PARP inhibitors (PARPis) for the treatment of metastatic breast cancer (MBC).
Clinicopathologic Features and Digital Imaging Analysis of HER2 Protein in Breast Carcinomas With Different HER2 Fluorescence in Situ Hybridization Patterns
Li AC, Hammond S, Crosby D, Li Z and Parwani AV
HER2-targeted therapies have significantly improved outcomes for patients with HER2-positive breast cancer (BC), which represents 15% to 20% of all BC cases. HER2 status is assessed via immunohistochemistry (IHC) and/or in situ hybridization (ISH), dividing BCs into five groups (G1-G5).
Assessing and Comparing the Diagnostic Effectiveness of [F]FDG PET/CT and [F]FDG PET/MRI for Distant Metastases in Breast Cancer Patients With Invasive Lobular Carcinoma Histology: An Ongoing Topic of Debate?
Altundag K
A Clinical Review of Subcutaneous Trastuzumab and the Fixed-Dose Combination of Pertuzumab and Trastuzumab for Subcutaneous Injection in the Treatment of HER2-Positive Breast Cancer
Ziegengeist JL and Tan AR
Therapy directed against human epidermal growth factor receptor type 2 (HER2) is the standard of care for patients with early-stage and metastatic HER2-positive breast cancer. Treating patients with HER2-positive breast cancer with anti-HER2-monoclonal antibodies, specifically trastuzumab and pertuzumab, is considered standard of care in the neoadjuvant and adjuvant settings and in the first-line setting for metastatic HER2-positive breast cancer. Pertuzumab and trastuzumab are commonly administered intravenously. Subcutaneous (SC) formulations of trastuzumab alone and as a combined product of pertuzumab and trastuzumab are now available for clinical use. Phase III trial results demonstrate that the efficacy and safety of SC trastuzumab and fixed-dose combination of pertuzumab, trastuzumab, and hyaluronidase-zzxf for subcutaneous (PH FDC SC) injection and the intravenous (IV) formulation counterparts are comparable. SC formulations of anti-HER2 monoclonal antibodies offer several advantages over IV counterparts, including shorter administration time, less need for IV access, and better resource utilization for treatment facilities. This review summarizes the clinical data supporting the use of SC trastuzumab and PH FDC SC injection in treating early-stage and metastatic HER2-positive breast cancer and highlights the benefits of SC injection compared to the IV formulations.
Engaging Multidisciplinary Teams to Develop Pragmatic Clinical Practice Guidelines to Support Management of Patients With High-Risk Breast Lesions
Neuman HB, Wilke LG, Bozzuto LM, Stelle L, Melnick D, Elezaby M, Woods RW, Chase P, McGregor S, Harter J, Weissman P, Greenberg CC, Burnside E, Fowler AM, DeMartini WB, Salkowski LR and Strigel RM
We sought to develop clinical guidelines within our multidisciplinary Breast Center to support decision-making for managing high-risk breast lesions. The objective is to describe the process used to develop these guidelines and assess perceived acceptability.
Navigating Lymphedema: The Impact of Indocyanine Green Lymphography on Personalized Therapy Outcomes in Breast Cancer Patients
Soran A, Senol K and Lupinacci K
To evaluate the role of Indocyanine Green Lymphography (ICG_L) in the early diagnosis and personalized management of breast cancer-related lymphedema (BCRL) among high-risk breast cancer (BC) survivors.
Real World Evidence Study to Assess Incidence, Treatment Patterns, Clinical Outcomes, and Health Care Resource Utilization in Early-Stage, High-Risk HER2-Negative Breast Cancer in Alberta, Canada
Henning JW, Boyne DJ, Brenner DR, Carbonell C, Shokar S, Granados DP, Parackal A and Cheung WY
Data are needed to improve the current understanding of the epidemiology of patients with high-risk, HER2-negative, early breast cancer (eBC) (hormone receptor positive [HR+]/HER2-negative BC and triple-negative BC [TNBC]).
Local Recurrence and Survival Outcomes of Multifocal/Multicentric Breast Cancer After Breast Conserving Therapy: A systematic Review and Meta-Analysis
Sun Y, Gao L, Zhou X, Wang Z, Li Y and Sun Q
The appropriateness of BCT for MF/MCBC is debated, with concerns about higher recurrence rates. This study aims to provide an updated systematic review and meta-analysis of LR and survival outcomes for MF/MCBC patients undergoing BCT.
Letter to the Editor Regarding the Article "The Impact of COVID-19 on Breast Cancer Care: A Qualitative Analysis of Surgeons' Perspectives"
Viswanathan A, Ganesh PS, Pathoor NN and Gopal RK
The COVID-19 pandemic exposed significant challenges in breast cancer care including healthcare inequities, limited access to surgeries, and difficulties in delivering virtual care. This letter builds upon the findings from the article "The Impact of COVID-19 on Breast Cancer Care" and proposes innovative solutions to address these challenges. Key suggestions include the use of AI-powered digital platforms for remote monitoring, robotic-assisted surgery for enhanced precision, mobile health applications for marginalized populations, and 3D printing for personalized breast reconstruction. Additionally, wearable health devices, nanotechnology for targeted drug delivery, and blockchain for secure medical data sharing are proposed to further improve the future of breast cancer care. These innovations offer practical approaches to overcoming the obstacles highlighted during the pandemic and aim to create a more equitable and efficient healthcare system.
Nonpharmacological Interventions for Postmastectomy Pain Syndrome-A Systematic Review of the Literature
Gónima Valero E, Rodríguez Miranda CD, Contreras Arrieta S, Daza Morelli MI, Seija Butnaru D, Reyes Carrillo M, Aponte Camacho LD and Amaya S
Literature regarding nonpharmacological interventions (NPI) for PMPS or CP after mastectomy is scarce and not fully appraised, therefore we conducted this systematic review to explore the current panorama of treatment options.
Transforming Breast Cancer Care and Clinical Outcomes: Local Experience in Yanbu Industrial City, Saudi Arabia
Ibrahim HS, Albeshan SM and ElRefaei MA
This study aimed to enhance outcomes for women undergoing breast cancer screening in a low utilization setting by implementing structured improvement cycles.
USP4/CARM1 Axis Promotes the Malignant Transformation of Breast Cancer Cells by Upregulating SLC7A11 Expression
Li X, Yan C, Yun J, Xu X, Wei H, Xu X, Li Y and Yi J
Coactivator associated arginine methyltransferase 1 (CARM1) has been identified as a regulator of breast cancer (BC) progression, yet the underlying mechanisms remain elusive.
Effect of Breast Cancer Receptor Subtypes and CSF Cytology Status on Survival of Patients With Leptomeningeal Disease
Niraula S, Gouli S, Baran AM, O'Regan R, Tyburski H, Zhang H, Hardy S, Mohile N, Anders CK and Dhakal A
It is unclear whether breast cancer (BC) subtypes or CSF cytology results are associated with overall survival (OS) among patients with BC leptomeningeal disease (LMD). This single-institution retrospective study compares OS among BC patients with LMD across various breast cancer subtypes and CSF cytology results.
Development and Validation of a Novel Conditional Survival Nomogram for Predicting Real-Time Prognosis in Patients With Breast Cancer Brain Metastasis
Zhang Y, Zhang M, Yu G and Wang W
Breast cancer brain metastasis (BCBM) prognosis has not been evaluated dynamically, which may underestimate patient survival. This study aimed to perform a conditional survival (CS) analysis and develop and validate an individualized real-time prognostic monitoring model for survivors.
The Systemic Immune-Inflammation Index is a Predictor of Chemotherapy Sensitivity and Disease-Free Survival in Patients With Hormone Receptor-Positive Human Epidermal Growth Factor Receptor 2-Negative Breast Cancer
Liu X, Yan G, Pang J, Xiao Z and Xie H
The relationship between the systemic immune-inflammation index (SII), chemotherapy sensitivity, and prognosis in HR+HER2- breast cancer (BC) has not been extensively studied.
Disparities in Hereditary Genetic Testing in Patients with Triple Negative Breast Cancer
Gupta S, Jones JE and Smith-Graziani D
Triple-negative breast cancer (TNBC) is an aggressive subtype of breast cancer that disproportionately affects younger females, non-Hispanic Black women, Hispanic women, and women with the BRCA1 gene mutation. Hereditary genetic testing is particularly important in this population to assess preventative and treatment strategies, however access to genetic testing is variable. A qualitative review was performed to evaluate barriers to genetic testing for patients with TNBC. Mutations common in breast cancer are reviewed along with updated guidelines on management strategies, including the ability to include PARP inhibitors as a treatment strategy. Barriers to genetic testing are multifactorial, with non-Hispanic Black women being tested less often than other groups. The disparity is even further represented by the limited number of non-Hispanic Black patients with TNBC who receive risk-reducing surgery or targeted systemic therapy. Eliminating barriers to genetic testing can allow us to support guideline-directed care for patients with TNBC at higher risk for genetic mutations.
Trends and Regional Differences for Fertility Preservation Procedures in Women With Breast Cancer
Turan V, Bedoschi G, Lee DY, Barbosa CP, de Oliveira R, Sacinti KG, Sonmezer M, Lambertini M, Massarotti C, Schaub A, Wang E, Gayete-Lafuente S, Dunlop C, Anderson RA, Bang H and Oktay KH
Breast cancer is the most common malignancy in women of reproductive age and chemotherapy protocols impair fertility, frequently necessitating fertility preservation (FP) referral. Embryo, oocyte, or ovarian tissue cryopreservation are established FP modalities in women with breast cancer but there are few data on their uptake over time. In this study our aim was to determine the regional time trends and utility differences for fertility preservation methods of reproductive tissue cryopreservation.
Prediction of Microinvasion in Breast Ductal Carcinoma in Situ Using Conventional Ultrasound Combined with Contrast-Enhanced Ultrasound Features: A Two-Center Study
Wu T, Chen J, Shao S, Du Y, Li F, Liu H, Sun L, Diao X and Wu R
To develop and validate a model based on conventional ultrasound (CUS) and contrast-enhanced ultrasound (CEUS) features to preoperatively predict microinvasion in breast ductal carcinoma in situ (DCIS).
Comparison of [F] FDG PET/CT and [F]FDG PET/MRI in the Detection of Distant Metastases in Breast Cancer: A Meta-Analysis
Shen F, Liu Q, Wang Y, Chen C and Ma H
This meta-analysis aims to assess and compare the diagnostic effectiveness of [F] FDG PET/CT and [F] FDG PET/MRI for distant metastases in breast cancer patients.
Effective Strategies for the Prevention and Mitigation of Phosphatidylinositol-3-Kinase Inhibitor-Associated Hyperglycemia: Optimizing Patient Care
Moore HN, Goncalves MD, Johnston AM, Mayer EL, Rugo HS, Gradishar WJ, Zylla DM and Bergenstal RM
Hyperglycemia is a common adverse event (AE) associated with phosphatidylinositol-3-kinase inhibitors (PI3Kis) and considered an on-target effect. Presence of hyperglycemia is associated with poor outcomes in patients with cancer, and there is need for further refinement of hyperglycemia prevention and mitigation strategies in patients receiving PI3Kis. In this review, the authors highlight effective strategies for preventing PI3Ki-induced hyperglycemia before and during treatment as well as hyperglycemia management. Prior to initiating treatment with PI3Ki, identify baseline risk factors of patients at increased risk for developing hyperglycemia, which include older age, obesity, and glycosylated hemoglobin (HbA1c) 5.7%-6.4% (prediabetes or Type 2 diabetes). To prevent new-onset hyperglycemia, optimize blood glucose, and recommend a low-carbohydrate (60-130 g/day) diet along with regular exercise to all patients prior to initiating the PI3Ki. Prophylactic metformin may be considered in all patients starting a PI3Ki with HbA1c ≤6.4%. Although existing recommendations support monitoring fasting blood glucose (FBG) once weekly (twice-weekly for intermediate-risk, daily for high-risk patients) and HbA1c every 3 months upon initiation of PI3Ki, more frequent FBG monitoring may be considered for prompt detection of hyperglycemia. Experts also recommend considering postprandial glucose monitoring because it is an early indicator of glucose intolerance. If hyperglycemia develops, metformin (first-line) and/or sodium glucose co-transporter 2 inhibitors or thiazolidinediones (second-/third-line) are the preferred agents; consider early referral to an endocrinologist. In conclusion, hyperglycemia is a common but manageable AE associated with PI3Kis. Multidisciplinary approach to the prevention, monitoring, and management of hyperglycemia optimizes patient care and allows patients to maintain therapy on PI3Ki.
RBM15 Drives Breast Cancer Cell Progression and Immune Escape via m6A-Dependent Stabilization of KPNA2 mRNA
Wang H, Cao Y, Zhang L, Zhao Q, Li S and Li D
Breast cancer is the most frequently diagnosed cancer among women worldwide with high morbidity and mortality. Previous studies have indicated that RNA-binding motif protein-15 (RBM15), an N6-methyladenosine (m6A) writer, is implicated in the growth of breast cancer cells. Herein, we aimed to explore the function and detailed mechanism of RBM15 in breast cancer.