@article{MTMT:34612989,
	title = {Multi-MicroRNA Analysis Can Improve the Diagnostic Performance of Mammography in Determining Breast Cancer Risk},
	url = {https://m2.mtmt.hu/api/publication/34612989},
	author = {Song, Ji-Eun and Jang, Ji Young and Kang, Kyung Nam and Jung, Ji Soo and Kim, Chul Woo and Kim, Ah Sol},
	doi = {10.1155/2023/9117047},
	journal-iso = {BREAST J},
	journal = {BREAST JOURNAL},
	volume = {2023},
	unique-id = {34612989},
	issn = {1075-122X},
	abstract = {The objective of this study was to determine whether multi-microRNA analysis using a combination of four microRNA biomarkers (miR-1246, 202, 21, and 219B) could improve the diagnostic performance of mammography in determining breast cancer risk by age group (under 50 vs. over 50) and distinguish breast cancer from benign breast diseases and other cancers (thyroid, colon, stomach, lung, liver, and cervix cancers). To verify breast cancer classification performance of the four miRNA biomarkers and whether the model providing breast cancer risk score could distinguish between benign breast disease and other cancers, the model was verified using nonlinear support vector machine (SVM) and generalized linear model (GLM) and age and four miRNA qRT-PCR analysis values (dCt) were input to these models. Breast cancer risk scores for each Breast Imaging-Reporting and Data System (BI-RADS) category in multi-microRNA analysis were analyzed to examine the correlation between breast cancer risk scores and mammography categories. We generated two models using two classification algorithms, SVM and GLM, with a combination of four miRNA biomarkers showing high performance and sensitivities of 84.5% and 82.1%, a specificity of 85%, and areas under the curve (AUCs) of 0.967 and 0.965, respectively, which showed consistent performance across all stages of breast cancer and patient ages. The results of this study showed that this multi-microRNA analysis using the four miRNA biomarkers was effective in classifying breast cancer in patients under the age of 50, which is challenging to accurately diagnose. In addition, breast cancer and benign breast diseases can be classified, showing the possibility of helping with diagnosis by mammography. Verification of the performance of the four miRNA biomarkers confirmed that multi-microRNA analysis could be used as a new breast cancer screening aid to improve the accuracy of mammography. However, many factors must be considered for clinical use. Further validation with an appropriate screening population in large clinical trials is required. This trial is registered with (KNUCH 2022-04-036).},
	year = {2023},
	eissn = {1524-4741}
}

@article{MTMT:34300441,
	title = {Hormonal-Receptors-Positive and HER2-Negative Patients with Metastatic Breast Cancer Treated with First-Line Palbociclib and Hormonal Therapy: Impact of First-Cycle Neutropenia and Dose Reduction on Therapeutic Outcome},
	url = {https://m2.mtmt.hu/api/publication/34300441},
	author = {Elnaghi, Khaled Abd Elaziz Ahmed and Alghanmi, Hosam Ali and Elsamany, Shereef Ahmed and Almarzoki, Fathia and Elsafty, Mohamed and Jaffal, Mohammad},
	doi = {10.1155/2023/8994954},
	journal-iso = {BREAST J},
	journal = {BREAST JOURNAL},
	volume = {2023},
	unique-id = {34300441},
	issn = {1075-122X},
	abstract = {Background. CDK 4/6 inhibitors with hormonal therapy are the standard first-line therapy in metastatic hormonal receptors (HR)-positive and HER2-negative breast cancer. This study aims to assess the impact of neutropenia with 1st cycle, dose reduction, HER2-low status, and other clinicopathological factors on survival outcomes with the first-line palbociclib and hormonal therapy. Patients and Methods. In this retrospective study, we recruited patients with metastatic HR-positive and HER2-negative breast cancer. Neutropenia with 1st cycle, palbociclib dose reduction in addition to different clinicopathological and survival data were checked in patients' medical records. Survival outcomes were compared according to the abovementioned factors. Results. We recruited 150 patients who received first-line palbociclib with hormonal therapy. 86% of patients developed 1st cycle neutropenia which was more common in patients with high Ki67. Dose reduction was recorded in 46.7% of patients and it was more common in patients with higher Allred scores (scores 7-8). The median progression-free survival (PFS) of the study group was 22 months. No significant difference was observed in PFS according to the 1st cycle of neutropenia or grade of neutropenia. Similarly, no difference in PFS according to palbociclib dose reduction and HER2 low status was observed. Only the Allred score and having a single site of metastasis had an independent significant relation with PFS. The median overall survival (OS) of the study group was 39 months. No significant difference was observed in OS according to the 1st cycle neutropenia, grade of neutropenia, palbociclib dose reduction, and HER2-low status. Only the Allred score and having a single site of metastasis had an independent significant relation with OS. In addition, no difference was observed in PFS and OS according to ECOG PS (2 vs. 0-1) or menopausal status. Conclusion. No significant impact of the 1st cycle neutropenia, dose reduction, having ECOG PS2, menopausal status, or HER2 low status on survival outcome was observed. Survival outcome was significantly better in patients with single metastatic sites and higher ER-Allred scores.},
	year = {2023},
	eissn = {1524-4741}
}

@article{MTMT:34039665,
	title = {Impact of CDK4/6 Inhibitors on Aromatase Inhibitor-Associated Musculoskeletal Syndrome (AIMSS) in the Adjuvant Setting},
	url = {https://m2.mtmt.hu/api/publication/34039665},
	author = {Skafida, E. and Andrikopoulou, A. and Terpos, E. and Markellos, C. and Moustafa, S. and Pectasides, D. and Dimopoulos, M.-A. and Zagouri, F. and Vassilopoulos, D.},
	doi = {10.1155/2023/3614296},
	journal-iso = {BREAST J},
	journal = {BREAST JOURNAL},
	volume = {2023},
	unique-id = {34039665},
	issn = {1075-122X},
	year = {2023},
	eissn = {1524-4741}
}

@article{MTMT:33911892,
	title = {Predicting of Ki-67 Expression Level Using Diffusion-Weighted and Synthetic Magnetic Resonance Imaging in Invasive Ductal Breast Cancer},
	url = {https://m2.mtmt.hu/api/publication/33911892},
	author = {Zhang, Liying and Hao, Jisen and Guo, Jia and Zhao, Xin and Yin, Xing},
	doi = {10.1155/2023/6746326},
	journal-iso = {BREAST J},
	journal = {BREAST JOURNAL},
	volume = {2023},
	unique-id = {33911892},
	issn = {1075-122X},
	abstract = {Objectives. To investigate the association between quantitative parameters generated using synthetic magnetic resonance imaging (SyMRI) and diffusion-weighted imaging (DWI) and Ki-67 expression level in patients with invasive ductal breast cancer (IDC). Method. We retrospectively reviewed the records of patients with IDC who underwent SyMRI and DWI before treatment. Precontrast and postcontrast relaxation times (T1, longitudinal; T2, transverse), proton density (PD) parameters, and apparent diffusion coefficient (ADC) values were measured in breast lesions. Univariate and multivariate regression analyses were performed to screen for statistically significant variables to differentiate the high (=30%) and low (<30%) Ki-67 expression groups. Their performance was evaluated by receiver operating characteristic (ROC) curve analysis. Results. We analyzed 97 patients. Multivariate regression analysis revealed that the high Ki-67 expression group (n = 57) had significantly higher parameters generated using SyMRI (pre-T1, p = 0.001) and lower ADC values (p = 0.036) compared with the low Ki-67 expression group (n = 40). Pre-T1 showed the best diagnostic performance for predicting the Ki-67 expression level in patients with invasive ductal breast cancer (areas under the ROC curve (AUC), 0.711; 95% confidence interval (CI), 0.609-0.813). Conclusions. Pre-T1 could be used to predict the pretreatment Ki-67 expression level in invasive ductal breast cancer.},
	year = {2023},
	eissn = {1524-4741}
}

@article{MTMT:34216976,
	title = {Development of the Breast Surgical Oncology Fellowship in the United States},
	url = {https://m2.mtmt.hu/api/publication/34216976},
	author = {Westcott, L.Z. and Jones, R.C. and Fleshman, J.W.},
	doi = {10.1155/2022/3342910},
	journal-iso = {BREAST J},
	journal = {BREAST JOURNAL},
	volume = {2022},
	unique-id = {34216976},
	issn = {1075-122X},
	year = {2022},
	eissn = {1524-4741}
}

@article{MTMT:33357670,
	title = {The Importance of the Pathological Perspective in the Management of the Invasive Lobular Carcinoma},
	url = {https://m2.mtmt.hu/api/publication/33357670},
	author = {Tasli, Funda and Cavdar, Demet and Kececi, Sibel Demir and Zengel, Baha and Adibelli, Zehra Hilal and Dal, Gamze and Gonen, Irem and Oz, Ozden and Yilmaz, Cengiz and Ozdemir, Ozlem and Mollamehmetoglu, Hulya and Dilek, Ismail and Ilhan, Enver and Uslu, Adam},
	doi = {10.1155/2022/2461242},
	journal-iso = {BREAST J},
	journal = {BREAST JOURNAL},
	volume = {2022},
	unique-id = {33357670},
	issn = {1075-122X},
	abstract = {Background. Invasive lobular carcinomas (ILC) account for 10-15% of all breast cancers and are the second most common histological form of breast cancer. They usually show a discohesive pattern of single cell infiltration, tend to be multifocal, and the tumor may not be accompanied by a stromal reaction. Because of these histological features, which are not common in other breast tumors, radiological detection of the tumor may be difficult, and its pathological evaluation in terms of size and spread is often problematic. The SSO-ASTRO guideline defines the negative surgical margin in breast-conserving surgeries as the absence of tumor detection on the ink. However, surgical margin assessment in invasive lobular carcinomas has not been much discussed from the pathological perspective. Methods. The study included 79 cases diagnosed with invasive lobular carcinoma by a Tru-cut biopsy where operated in our center between 2014 and 2021. Clinicopathological characteristics of the cases, results of an intraoperative frozen evaluation in cases that underwent conservative surgery, the necessity of re-excision and complementary mastectomy, and consistency in radiological and pathological response evaluation in cases receiving neoadjuvant treatment were questioned. Results. The tumor was multifocal in 37 (46.8%) cases and single tumor focus in 42 (53.2%) cases. When the entire patient population was evaluated, regardless of focality, mastectomy was performed in 27 patients (34.2%) and breast-conserving surgery (BCS) was performed in 52 patients (65.8%). Of the 52 patients who underwent BCS, 26 (50%) required an additional surgical procedure (cavity revision or completion mastectomy). There is a statistical relationship between tumor size and additional surgical intervention (p < 0.05). BCS was performed in 7 of 12 patients who were operated on after neoadjuvant treatment, but all of them were reoperated with the same or a second session and turned to mastectomy. Neoadjuvant treatment and the need for reoperation were statistically significant (p < 0.05). Additional surgical procedures were performed in 20 (44.4%) of 45 patients in BCS cases who did not receive neoadjuvant therapy. Conclusions. Diagnostic difficulties in the intraoperative frozen evaluation of invasive lobular carcinoma are due to the different histopathological patterns of the ILC. In our study, it was determined that large tumor size and neoadjuvant therapy increased the need for additional surgical procedures. It is thought that the pathological perspective is the determining factor in order to minimize the negative effects such as unsuccessful cosmesis, an additional surgical burden on the patient, and cost increase that may occur with additional surgical procedures; for this reason, new approaches should be discussed in the treatment planning of invasive lobular carcinoma cases.},
	year = {2022},
	eissn = {1524-4741}
}

@article{MTMT:33357089,
	title = {Neoadjuvant Trastuzumab and Pertuzumab for Early HER2-Positive Breast Cancer: A Real World Experience},
	url = {https://m2.mtmt.hu/api/publication/33357089},
	author = {Hall, Benjamin James and Bhojwani, Ajay Ashok and Wong, Helen and Law, Andrea and Flint, Helen and Ahmed, Eliyaz and Innes, Helen and Cliff, Joanne and Malik, Zaf and O'Hagan, Julie Elizabeth and Hall, Allison and Sripadam, Rajaram and Tolan, Shaun and Ali, Zulfiqar and Hart, Clare and Errington, Douglas and Alam, Farida and Giuliani, Rosa and Mehta, Shaveta and Khanduri, Sheena and Thorp, Nicky and Jackson, Richard and Cicconi, Silvia and Palmieri, Carlo},
	doi = {10.1155/2022/7146172},
	journal-iso = {BREAST J},
	journal = {BREAST JOURNAL},
	volume = {2022},
	unique-id = {33357089},
	issn = {1075-122X},
	abstract = {Background. Randomized studies of neoadjuvant (NA) trastuzumab and pertuzumab combined with chemotherapy for HER2-positive breast cancers (BC) have reported pathological complete response (pCR) rates of 39 to 61%. This study aimed to determine the real-world efficacy and toxicity of NA trastuzumab and pertuzumab combined with chemotherapy in a UK tertiary referral cancer centre. Methods. HER2-positive early BC patients given neoadjuvant chemotherapy with trastuzumab and pertuzumab between October 2016 and February 2018 at our tertiary referral cancer centre were identified via pharmacy records. Clinico-pathological information, treatment regimens, treatment-emergent toxicities, operative details, and pathological responses and outcomes were recorded. Results. 78 female patients were identified; 2 had bilateral diseases and 48 of 78 (62%) were node positive at presentation. 55 of 80 (71%) tumours were ER-positive. PCR occurred in 37 of 78 (46.3%; 95% CI: 35.3-57.2%) patients. 14 of 23 (60.8%) patients with ER-negative tumours achieved pCR; 23 of 55 (41.8%) were ER-positive and 6 of 19 (31.6%) were ER-positive and PgR-positive. No cardiac toxicity was documented. Diarrhoea occurred in 53 of 72 (74%) patients. Grade 3-4 toxicity occurred in >= 2% patients. These were diarrhoea, fatigue, and infection. The Median follow up period was 45.2 months (95% CI 43.8-46.3) with 71 of 78 (91.0%) remaining disease-free and 72 of 78 (92.3%) alive. Estimated OS at 2 years 86% (95% CI: 75-99%). Conclusion. This data confirms the efficacy of neoadjuvant chemotherapy combined with dual HER2 directed therapy. While no cardiac toxicity was observed, diarrhoea occurred frequently. The low pCR rate observed in ER and PgR-positive BCs warrants further investigation and consideration of strategies to increase the pCR rate.},
	year = {2022},
	eissn = {1524-4741}
}

@article{MTMT:33344522,
	title = {The Accuracy of Electrical Impedance Tomography for Breast Cancer Detection: A Systematic Review and Meta-Analysis},
	url = {https://m2.mtmt.hu/api/publication/33344522},
	author = {Gatabi, Zahra Rezanejad and Mirhoseini, Mehri and Khajeali, Nasrin and Gatabi, Iman Rezanezhad and Dabbaghianamiri, Maedeh and Dorri, Sara},
	doi = {10.1155/2022/8565490},
	journal-iso = {BREAST J},
	journal = {BREAST JOURNAL},
	volume = {2022},
	unique-id = {33344522},
	issn = {1075-122X},
	abstract = {Introduction. Incidence of breast cancer (BC) in 2020 is about 2.26 million new cases. It is the first common cancer accounting for 11.7% of all cancer worldwide. Disease complications and the mortality rate of breast cancer are highly dependent on the early diagnosis. Therefore, novel human breast-imaging techniques play an important role in minimizing the breast cancer morbidity and mortality rate. Electrical impedance tomography (EIT) is a noninvasive technique to image the breast using the electrical impedance behavior of the body tissues. Objectives. The aims of this manuscript are as follows: (1) a comprehensive investigation of the accuracy of EIT for breast cancer diagnosis through searching pieces of evidence in the valid databases and (2) meta-analyses of the results. Methods. The systematic search was performed in the electronic databases including PubMed, Web of Science, EMBASE, Science Direct, ProQuest, Scopus, and Google Scholar without time and language limitation until January 2021. Search terms were "EIT" and "Breast Cancer" with their synonyms. Relevant studies were included based on PRISMA and study objectives. Quality of studies and risk of bias were performed by QUADAS-2 tools. Then, relevant data were extracted in Excel form. The hierarchical/bivariate meta-analysis was performed with "metandi" package for the ROC plot of sensitivity and specificity. Forest plot of the Accuracy index and double arcsine transformations was applied to stabilize the variance. The heterogeneity of the studies was evaluated by the forest plots, chi 2 test (assuming a significance at the a-level of 10%), and the I-2 statistic for the Accuracy index. Results. A total of 4027 articles were found. Finally, 12 of which met our criteria. Overall, these articles included studies of 5487 breast cancer patients. EIT had an overall pooled sensitivity and specificity of 75.88% (95% CI, 61.92% to 85.89%) and 82.04% (95% CI, 69.72% to 90.06%), respectively. The pooled diagnostic odds ratio was 14.37 (95% CI, 6.22% to 33.20%), and the pooled effect of accuracy was 0.79 with 95% CI (0.73, 0.83). Conclusions. This study showed that EIT can be used as a useful method alongside mammography. EIT sensitivity could not be compared with the sensitivity of MRI, but in terms of specificity, it can be considered as a new method that probably can get more attention. Furthermore, large-scale studies will be needed to support the evidence.},
	year = {2022},
	eissn = {1524-4741},
	orcid-numbers = {Dorri, Sara/0000-0002-0085-0115}
}

@article{MTMT:33343252,
	title = {Ductal Carcinoma In Situ (DCIS) Diagnosed by MRI-Guided Biopsy among BRCA1/BRCA2 Mutation Carriers},
	url = {https://m2.mtmt.hu/api/publication/33343252},
	author = {Faermann, Renata and Friedman, Eitan and Kaidar-Person, Orit and Weidenfeld, Jonathan and Brodsky, Malka and Shalmon, Anat and Neiman, Osnat Halshtok and Gotlieb, Michael and Yagil, Yael and Samoocha, David and Feldman, Dana Madorsky and Sklair-Levy, Miri},
	doi = {10.1155/2022/4317693},
	journal-iso = {BREAST J},
	journal = {BREAST JOURNAL},
	volume = {2022},
	unique-id = {33343252},
	issn = {1075-122X},
	abstract = {Background. While BRCA1/BRCA2 pathogenic sequence variants (PSVs) clearly confer an increased risk for invasive breast cancer, the extent to which these mutant alleles increase DCIS risk is less clear. Objective. To assess the rate of detection over a 5-year period, and MRI imaging features of pure noncalcified DCIS in a cohort of Israeli BRCA1/BRCA2 PSV carriers attending a high-risk clinic from 2015 to 2020. Materials and Methods. All female BRCA1/BRCA2 PSV-carriers followed at the Meirav High-risk clinic from 2015 to 2020 were eligible if they underwent semiannual breast imaging (MRI/mammography) and MRI-guided biopsy-proven pure DCIS. Clinical data, pathology information, and imaging characteristics were retrieved from the computerized archiving system. Results. 18/121 (15.2%) participating BRCA1 PSV carriers and 8/81 (10.1%) BRCA2 PSV-carriers who underwent MRI-guided biopsy were diagnosed with DCIS. The median age of BRCA1 carriers and BRCA2 carriers was 49.8 years and 60.6 years, respectively (p=0.55). Negative estrogen-receptor tumors were diagnosed in 13/18 (72%) BRCA1 and 2/8 (25%) BRCA2 PSV carriers (p < 0.05). Thirteen (13/18-72%) BRCA1 carriers had intermediate to high-grade or high-grade DCIS compared with 4/8 (50%) of BRCA2 carriers (p=0.03). Over the 5-year study period, 29/1100 (2.6%) BRCA1/BRCA2 PSV carriers were diagnosed with DCIS seen on MRI only. Conclusion. MRI-detected noncalcified DCIS is more frequent in BRCA1 PSV carriers compared with BRCA2 carriers, unlike the BRCA2 predominance in mammography-detected calcified DCIS. BRCA1-related DCIS is diagnosed earlier, more likely to be estrogen receptor-negative and of higher grade compared with BRCA2-related DCIS. Future prospective studies should validate these results and assess the actual impact they might have on clinical management of BRCA PSV carriers.},
	year = {2022},
	eissn = {1524-4741}
}

@article{MTMT:33341063,
	title = {Accuracy and Limitations of Sentinel Lymph Node Biopsy after Neoadjuvant Chemotherapy in Breast Cancer Patients with Positive Nodes},
	url = {https://m2.mtmt.hu/api/publication/33341063},
	author = {Aragon-Sanchez, Sofia and Reyes, Oliver-Perez M. and Madariaga, Ainhoa and Jose, Tabuenca M. and Martinez, Mario and Galindo, Alberto and Luisa, Arroyo M. and Gallego, Marta and Blanco, Marta and Ciruelos-Gil, Eva M.},
	doi = {10.1155/2022/1507881},
	journal-iso = {BREAST J},
	journal = {BREAST JOURNAL},
	volume = {2022},
	unique-id = {33341063},
	issn = {1075-122X},
	abstract = {Background. Axillary surgical management in patients with node-positive breast cancer at the time of diagnosis converted to negative nodes through neoadjuvant chemotherapy (NAC) remains unclear. Removal of more than two sentinel nodes (SLNs) in these patients may decrease the false negative rate (FNR) of sentinel lymph node biopsies (SLNBs). We aim to analyse the detection rate (DR) and the FNR of SLNB assessment according to the number of SLNs removed. Methods. A retrospective study was performed from October 2012 to December 2018. Patients with invasive breast cancer who had a clinically node-positive disease at diagnosis and with a complete axillary response after neoadjuvant chemotherapy were selected. Patients included underwent SLNB and axillary lymph node dissection (ALND) after NAC. The SLN was considered positive if any residual disease was detected. Descriptive statistics were used to describe the clinicopathologic features and the results of SLNB and ALND. The DR of SLNB was defined as the number of patients with successful identification of SLN. Presence of residual disease in ALND and negative SLN was considered false negative. Results. A total of 368 patients with invasive breast cancer who underwent surgery after complete NAC were studied. Of them, 85 patients met the eligibility criteria and were enrolled in the study. The mean age at diagnosis was 50.8 years. Systematic lymphadenectomy was performed in all patients, with an average of 10 lymph nodes removed. The DR of SLNB was 92.9%, and the FNR was 19.1. The median number of SLNs removed was 3, and at least, three SLNs were obtained in 42 patients (53.2%). When at least three sentinel nodes were removed, the FNR decreased to 8.7%. Conclusions. In this cohort, the SLN assessment was associated with an adequate DR and a high FNR. Removing three or more SLNs decreased the FNR from 19.1% to 8.7%. Complementary approaches may be considered for axillary lymph node staging after neoadjuvant chemotherapy. The study was approved by our institution's ethics committee (Instituto de Investigacion Sanitaria Hospital 12 de Octubre (imas12), Universidad Complutense de Madrid, Madrid, Spain) ().},
	keywords = {injection; surgery; Oncology; Axillary ultrasound; INTERNATIONAL EXPERT CONSENSUS; PRIMARY THERAPY; BLUE-DYE; PERIAREOLAR},
	year = {2022},
	eissn = {1524-4741},
	orcid-numbers = {Madariaga, Ainhoa/0000-0001-7166-9762}
}