Journal of Breast Cancer

Prevalence of PD-L1 Positivity Using SP142 in Patients With Advanced Stage Triple-Negative Breast Cancer in Malaysia: A Cross-Sectional Study
Rajadurai P, Yap NY, Chiew SF, Md Zin RR, Md Pauzi SH, Jaafar ASB, Yahaya A and Looi LM
Triple-negative breast cancer (TNBC) is a subtype of breast cancer known for its poor prognosis and the absence of viable targets for standard receptor-based therapies. Several studies have suggested that targeting programmed death-ligand 1 (PD-L1) in tumors that express this biomarker, either on tumor cells and/or in the tumor inflammatory infiltrate, may be beneficial in some patients. This study aimed to assess the overall prevalence of PD-L1 positivity using the SP142 antibody clone in patients with advanced TNBC in Malaysia.
Characteristics and Prognosis of Breast Cancer Patients With Prior Hormone Replacement Therapy: Insights From the Korean Breast Cancer Society Registry
Kim CW, Jung Y, Jeong J, Kim HJ, Choi JE, Suh YJ, Kim KS, Park WC, Yoon CI, Lee YJ, Kim D, Bae SY and
By investigating the characteristics and prognosis of breast cancer (BC) patients who have undergone hormone replacement therapy (HRT), this study addresses a gap in the existing literature. A total of 17,355 postmenopausal patients with BC were analyzed using data from the Korea Breast Cancer Society database (2000-2014). Among them, 3,585 (20.7%) had a history of HRT before BC diagnosis (HRT group), while 13,770 (79.3%) never received HRT (non-HRT group). The HRT group exhibited an earlier pathologic stage, lower histologic and nuclear grades, and a higher rate of breast conservation surgery compared to the non-HRT group. Furthermore, this group had a higher rate of screening participation and a greater proportion of patients with a normal or overweight body mass index (BMI). The prognosis of the HRT group was better than that of the non-HRT group, with a 5-year overall survival rate of 93.9% versus 91.7% ( < 0.001). The hazard ratio for the HRT group was 0.7 (95% confidence interval, 0.608-0.805; < 0.001). Increased screening participation, longer HRT duration, and a normal or overweight BMI were associated with a better prognosis in the HRT group. Patients with BC who underwent HRT showed better clinicopathological characteristics and prognosis than those who did not receive HRT. The results highlighted significant differences in patients who underwent screening and those with a normal or overweight BMI. Furthermore, a longer HRT duration was associated with a better prognosis.
Variability in Breast Density Estimation and Its Impact on Breast Cancer Risk Assessment
Ji H, Jang MJ and Chang JM
Breast density is an independent risk factor for breast cancer, although variability exists in measurements. This study sought to evaluate the agreement between radiologists and automated breast density assessment software and assess the impact of breast density measures on breast cancer risk estimates using the Breast Cancer Surveillance Consortium (BCSC) model (v.2). A retrospective database search identified women who had undergone mammography between December 2021 and June 2022. The Breast Imaging Reporting and Data System (BI-RADS) breast composition index assigned by a radiologist (R) was recorded and analyzed using three commercially available software programs (S1, S2, and S3). The agreement rate and Cohen's kappa (κ) were used to evaluate inter-rater agreements concerning breast density measures. The 5-year risk of invasive breast cancer in women was calculated using the BCSC model (v.2) with breast density inputs from various density estimation methods. Absolute differences in risk between various density measurements were evaluated. Overall, 1,949 women (mean age, 53.2 years) were included. The inter-rater agreement between R, S1, and S2 was 75.0-75.6%, while that between S3 and the others was 60.2%-63.3%. Kappa was substantial between R, S1, and S2 (0.66-0.68), and moderate (0.49-0.50) between S3 and the others. S3 placed fewer women in mammographic density d (14.9%) than R, S1, and S2 (40.5%-44.0%). In BCSC risk assessment (v.2), S3 assessed fewer women with a high 5-year risk of invasive breast cancer than the other methods, resulting in an absolute difference of 0% between R, S1, and S2 in 75.0%-75.6% of cases, whereas the difference between S3 and the other methods occurs in 60.2%-63.3% of cases. Breast density assessment using various methods showed moderate-to-substantial agreement, potentially affecting risk assessments. Precise and consistent breast density measurements may lead to personalized and effective strategies for breast cancer prevention.
Targeted Inhibition of p21 Promotes the Growth of Breast Cancer Cells and Impairs the Tumor-Killing Effect of the Vaccinia Virus
Jia X, Zhao Y, Li Q, Lu X, Wang X, Wang H, Shi Z, Xu Y, Huang B, Huang F and Wang Y
Vaccinia virus is widely used as an oncolytic agent for human cancer therapy, and several versions of vaccinia virus have demonstrated robust antitumor effects in breast cancer. Most vaccinia viruses are modified by thymidine kinase (TK) deletion. The function of the cyclin-dependent kinase inhibitor p21 in breast cancer remains controversial. We explored the impact of p21 gene knockdown (KD) on breast cancer cells and whether p21 KD interferes with the antitumor effect of TK-negative vaccinia virus.
p27 Cell Cycle Inhibitor and Survival in Luminal-Type Breast Cancer: Gene Ontology, Machine Learning, and Drug Screening Analysis
Park IA, Noh YK, Min KW, Kim DH, Lee JY, Son BK, Kwon MJ, Han MH, Hur JY and Pyo JS
A widely distributed cell cycle inhibitor, p27, regulates cyclin-dependent kinase-cyclin complexes. Although the prognostic value of p27 has been established for various types of carcinomas, its role in luminal breast cancer remains poorly understood. This study aimed to explore the functional enrichment of p27 and identify potential drug targets in patients with luminal-type breast cancer.
Risk of Lymphedema After Sentinel Node Biopsy in Patients With Breast Cancer
Byeon J, Kang E, Jung JJ, Cheun JH, Seo KS, Kim HK, Lee HB, Han W and Moon HG
Although numerous studies have identified potential risk factors for ipsilateral lymphedema development in patients with breast cancer following axillary node dissection, the risk factors for lymphedema in patients undergoing sentinel node biopsy without axillary dissection remain unclear. In this study, we aimed to determine the real-world incidence and risk factors for lymphedema in such patients.
Histopathological Downgrading of Borderline Phyllodes Tumor in a Young Patient Following Chemotherapy: A Case Report
Hara Y, Yamaguchi R, Otsubo R, Fukushima A, Inamasu E, Akashi M, Morita M, Kuba S, Eguchi S and Matsumoto K
Phyllodes tumors (PT) are fibroepithelial neoplasms that are treated by complete surgical excision. The effectiveness of adjuvant therapies, including radiotherapy and chemotherapy, for PT remains unclear, and the use of neoadjuvant chemotherapy (NAC) is yet to be established. We report a case of a 15-year-old girl with acute lymphatic leukemia (ALL) who was incidentally diagnosed with a 50-mm borderline PT in the left breast using computed tomography, ultrasonography, and histological examination following needle biopsy. Lumpectomy was performed after administration of anthracycline-based chemotherapy for ALL, resulting in tumor size reduction. Histopathological examination of the excised specimen demonstrated decreased mitotic activity and stromal cellularity post-chemotherapy. To our knowledge, this is the first study to report the histopathological differences in pre- and post-chemotherapy borderline PT samples. Our findings suggest that NAC may induce changes in borderline PT, potentially affecting diagnosis and treatment decisions. Hence, further investigation is warranted in this regard.
Breast Cancer Statistics in Korea, 2021
Cha CD, Park CS, Shin HC, Han J, Choi JE, Kim JH, Jung KW, Lee SB, Nam SE, Yoon TI, Kang YJ, Kim Z, Jung SY, Kim HA and
The Korean Breast Cancer Society (KBCS) has collected nationwide registry data on clinicopathologic characteristics and treatment since 1996. This study aimed to analyze the clinical characteristics of breast cancer in Korea and assess changes in breast cancer statistics for 2021 using data from the KBCS registry and the Korean Central Cancer Registry. In 2021, 34,628 women were newly diagnosed with breast cancer. The median age of women diagnosed with breast cancer was 53.4 years, with the highest incidence occurring in the 40-49 age group. The most common molecular subtype was hormone receptor-positive and human epidermal growth factor receptor 2 (HER2)-negative, accounting for 69.1% of cases, while HER2-positive subtypes comprised 19.3%. During the coronavirus disease 2019 pandemic, the national breast cancer screening rate declined. However, the incidence of early-stage breast cancer (stages 0 and I) continued to increase, accounting for 65.6% of newly diagnosed cases in 2021. Our results showed that the overall survival rate for patients with breast cancer has improved, primarily due to a rise in early-stage diagnoses and advancements in treatment.
Safety of Atypical Ductal Hyperplasia at the Nipple Margin in Nipple-Sparing Mastectomy
Zhu M, Mao J, Fang J and Chen D
Controversies persist regarding contraindications for nipple-sparing mastectomy (NSM). This study aimed to assess the accuracy of subareolar frozen section analysis and identify risk factors for nipple-areola complex (NAC) recurrence post NSM.
Effect of Interval Between Neoadjuvant Chemotherapy and Surgery on Oncological Outcomes in Poor Responders With Locally Advanced Breast Cancer
Long M, Li C, Mao K, Li Z, Li Z, Dong G, Zheng X, Gao S, Li Z, Yang G and Xie Y
The interval between neoadjuvant chemotherapy (NAC) and surgery for locally advanced breast cancer (LABC) remains controversial. At the same time, the prognostic effect of delayed surgery in patients with poor responses is currently unclear.
Unveiling the Potential of Drain Tip Cultures: Impact on Surgical Site Infections in Implant-Based Breast Reconstruction
Kim JY, Ma IZ and Hong KY
Surgical site infections (SSIs) remain a concern after implant-based breast reconstruction, despite preventive measures. These infections can have serious consequences. This study evaluated the correlation between drain tip culture results and SSIs in this patient population.
Intensive Surveillance for Women With Breast Cancer: A Multicenter Retrospective Study in Korea
Park S, Moon HG, Lee JW, Kim KS, Kim Z, Jung SY, Lee J, Lee SK, Chae BJ, Jung SU, Chun JW, Cheun JH and Youn HJ
This study evaluated the effectiveness of different surveillance intensities on morbidity and mortality in women with breast cancer.
The Risk of Deep Vein Thrombosis and Optimal Timing of Breast Cancer Surgery After COVID-19 Infection
Bi Z, Cheng WH, Wang WL and Wang YS
The aim of this study was to assess the risk of postoperative deep vein thrombosis (DVT) in breast cancer patients with coronavirus disease 2019 (COVID-19) to determine the optimal timing for surgery in the era of "post COVID-19 pandemic."
Is Adjuvant Chemotherapy Preceding Cyclin-Dependent Kinase 4/6 Inhibitor Therapy Beneficial?
Sorscher S
Palliative Radiotherapy for Symptomatic Primary Tumors in Patients With Locally Advanced Breast Cancer
Kim JS, Chang JS and Kim K
Breast cancer remains a significant health concern for women, with a significant number of women facing unresectable, symptomatic, and advanced disease that severely affects their quality of life. Palliative radiotherapy (RT) is a well-established modality for managing such cases and alleviating symptoms. Recent advancements in systemic therapies and the resulting increase in long-term survival rates have not only heightened the need for retreatment in certain patients, but have also emphasized the importance of achieving durable local control. Additionally, inconsistencies in RT referral timing and variations in disease severity and extent contribute to diverse RT objectives and expected outcomes. The optimal dose fractionation for RT remains underexplored. Furthermore, a deeper understanding of breast radiobiology, along with the introduction of ultra- and moderately hypofractionated regimens and the widespread adoption of conformal techniques such as intensity-modulated RT, has diversified the approaches in RT dose and target volume. This review aimed to provides a comprehensive summary of the current evidence on the efficacy, outcomes, and toxicity profiles of palliative RT for symptomatic breast cancer. It highlights the need for more optimized regimens and further research to address the evolving treatment landscape and differing expectations of patients and physicians regarding RT.
The 21-Gene Recurrence Score Assay Improved Multidisciplinary Treatment Compliance in Hormone Receptor-Positive, Human Epidermal Growth Factor Receptor 2-Negative Breast Cancer Patients: An Analysis of 2,323 Patients
Li L, Yu J, Shen K and Chen X
The 21-gene recurrence score (RS) can guide adjuvant chemotherapy decisions in the multidisciplinary treatment (MDT) of patients with early breast cancer. This study aimed to evaluate the influence of the 21-gene RS assay on patient' compliance with MDT and its association with disease outcomes.
Dosimetric Correlation of Acute Radiation Dermatitis in Patients With Breast Cancer Undergoing Hypofractionated Proton Beam Therapy Using Pencil Beam Scanning
Huang EY, Ho MW and Wang YM
Pencil-beam scanning (PBS) is a modern delivery technique used in proton beam therapy (PBT) to reduce normal tissue reactions. No dosimetric correlation between dermatitis and PBS has been reported for breast cancer. The current study aimed to investigate the factors associated with grade 2 or higher dermatitis in patients with breast cancer undergoing PBT using PBS.
Breast Cancer and Therapy-Related Cardiovascular Toxicity
Hwang HJ, Han SA and Sohn IS
The global incidence of breast cancer is on the rise, a trend also observed in South Korea. However, thanks to the rapid advancements in anticancer therapies, survival rates are improving. Consequently, post-treatment health and quality of life for breast cancer survivors are emerging as significant concerns, particularly regarding treatment-related cardiotoxicity. In this review, we delve into the cardiovascular complications associated with breast cancer treatment, explore surveillance protocols for early detection and diagnosis of late complications, and discuss protective strategies against cardiotoxicity in breast cancer patients undergoing anticancer therapy, drawing from multiple guidelines.
Neoadjuvant Chemotherapy Is Effective in Those Infected With SARS-CoV-2: The Real-World Experience of a Large Chinese Breast Cancer Center
Ma T, Ma T, Wang L and Wang H
During the major shift in China's policies on coronavirus disease 2019 (COVID-19), many residents will be infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) over a short period, including a few patients with breast cancer undergoing neoadjuvant chemotherapy (NAC). Moreover, it is unknown whether this comorbidity affects the efficacy of NAC for breast cancer and the patient's psychological state and quality of life (QOL). This study aims to answer these questions.
Undifferentiated Pleomorphic Sarcoma Mimicking Breast Implant-Associated Anaplastic Large Cell Lymphoma
Chandrasiri N, Taiwo O, Ahmed M, Malhotra A and El-Sheikh S
Breast implant augmentation is a low-risk procedure with few life-threatening complications, most commonly rupture or leakage and contraction of the capsule. Breast implant-associated (BIA) malignancies are rare. Anaplastic large cell lymphoma (ALCL) is the most well-known neoplastic condition associated with breast augmentation. Carcinomas arising in association with implants have been reported but are rarer than ALCL. BIA-mesenchymal tumors are extremely rare and most are locally aggressive fibromatosis. To date, only eight cases of BIA sarcomas have been reported. Herein, we describe a case of silicone BIA-undifferentiated pleomorphic sarcoma (UPS) that was initially mistaken for ALCL because of a significant clinical and radiological overlap in presentation and imaging. Here, we present the morphological and molecular features of this rare neoplasm. We reviewed the existing literature related to BIA sarcomas to highlight the importance of considering this diagnosis in cases of recurrent ALCL-negative BIA effusions.
Prediction of Oncotype DX Recurrence Score Based on Systematic Evaluation of Ki-67 Scores in Hormone Receptor-Positive Early Breast Cancer
Kim JM and Cho EY
Oncotype DX (ODX) predicts the risk of recurrence and benefits of adding chemotherapy for patients with estrogen receptor positive (ER+)/human epidermal growth factor receptor 2 negative (HER2-) early-stage breast cancer. We aimed to develop a simplified scoring system using readily available clinicopathological parameters to predict a high-risk ODX recurrence score (RS) while minimizing reproducibility issues regarding Ki-67 index evaluation methods.