Aim: This study examined the characteristics of HER2-low breast cancer patients in our center. Methods: Data of HER2-negative breast cancer patients were collected, and the patients were divided into HER2-low and HER2-0 groups. The differences in clinicopathological features, prognosis and treatment were compared. Results: The proportion of patients in the HER2-low group who were over 50 years old, had invasive breast cancer of no special type, histological grade 1/2, ER-positive, PR-positive and Ki67 ≤30% was higher. Patients with HER2-low status had better breast cancer-specific survival and overall survival. Additionally, HER2-low status was not associated with the effectiveness of adjuvant chemotherapy and endocrine therapy. Conclusion: HER2-low breast cancer is less aggressive than HER2-0 and may represent a distinct subtype.

Aim: Quantify the added benefit of preoperative magnetic resonance imaging (MRI) staging of invasive lobular carcinoma of the breast (ILC) in addition to conventional imaging with ultrasound and mammography (US/MMG). Methods: Retrospective study ILC patients at our center to investigate effect of MRI in detecting additional disease, as well as effects on subsequent surgical management, reoperation rates and disease recurrence. Results: Preoperative MRI detected additional disease in 30.4% and altered surgical management in 39.1%. MRI better predicted histopathological lesion size but did not significantly alter reoperation or recurrence rates. Conclusion: MRI is superior in ILC detection and upstages a significant proportion of patients when used in preoperative staging. The impact on surgical outcomes warrants further investigation in larger prospective studies.

Aim: We aimed to study the characteristics of the breast cancer patients with positive HER2/neu+, ER- and PR- receptors. Methods: 119 patients with breast cancer were included in this retrospective cohort study from 2006 to 2016. The overall and disease-free survival were evaluated. Results: Most prevalent type of tumor was IDC, grade III cancer and stage II. Recurrence/metastasis occurred in 18.49%. Most common sites of metastasis were lungs and liver. Total mortality rate was 10.92%. Overall and disease-free survival times were 40.04 and 22.29 months, respectively. The median survival time was about 118 months. Conclusion: Breast cancers with positive HER2/neu and negative estrogen and progesterone receptors had low overall and disease-free survival rates compared with ER+/PR+/HER2- tumors.

Aim: Italian real-world analysis of CDK4/6 inhibitor (CDK4/6i) treatment in HR+/HER2- metastatic breast cancer aimed at evaluating patients' medical history, treatment duration, treatment patterns (combination with endocrine therapy), line of therapy and drug dose variations. Materials & methods: CDK4/6i treatment was analyzed using healthcare administrative databases covering 18% of Italians between January 2017 and June 2022. Results: Among CDK4/6i-treated women, palbociclib and abemaciclib (were more frequently combined with fulvestrant, while ribociclib with aromatase inhibitors. CDK4/6i recommended doses were initiated in 72–90% patients and maintained after 3–6 months in respectively 65–57% women. Frontline CDK4/6i use grew over time (reaching 90%). Median time-to-treatment discontinuation was 11.0 months in palbociclib, 15.9 in abemaciclib and 15.4 in ribociclib cohorts. Conclusion: CDK4/6i plus endocrine therapy is increasingly utilized as first-line therapy, with low proportions of dose reductions within 6 months and discontinuations at 1 year.

Aim: This study aimed to find subgroups of women on the basis of clustering of breast cancer risk factors. Materials & methods: The study was conducted in Shiraz between 2004 and 2013. In this cross-sectional study clinical breast examination, mammography or sonography, fine needle aspiration or biopsy and surgery in case of indications were performed for all participants. Results: Four latent classes were indentified among women with breast cancer; general population risk (65.7%), low risk (8.9%), moderate risk (20.5%) and high risk (4.9%). Conclusion: Focusing on education, age and the occupation of women may help in designing and executing effective programs to reduce the incidence of breast cancer among healthy women.

Background: Triple-negative breast cancer (TNBC) is associated with a poor prognosis and requires more aggressive treatment. Aim: The study aimed to evaluate the prophetic role of the prolactin receptor (PRLR) in TNBC stratification. Materials & methods: In a retrospective study, 58 formalin-fixed paraffin-embedded tumor tissues from patients diagnosed with TNBC were examined for PRLR expression using immunohistochemistry. The potential associations between PRLR expression and tumor characteristics were assessed. Result: PRLR expression was negative in 36 (62%) patients and positive in 22 (38%) patients. The number of positive PRLR tumors was significantly higher in patients without lymph node involvement (p = 0.019). Conclusion: PRLR expression was negatively associated with lymph node invasion in TNBC.

Aim: Male breast cancer (MBC) is a rare disease and accounts for approximately 1% of breast cancer. Treatment is largely extrapolated from female breast cancer due to lack of data in MBC. However, there are distinct features of MBC that warrant different treatment approach. We aim to better characterize the risk factors, clinicopathologic features, treatment and outcome of MBC patients from six hospitals across Steward Healthcare Network. Materials & methods: A total of 107 men with breast cancer were identified from the respective cancer registry at Steward and 64 patients were included with complete medical records. Their clinical, histopathological and treatment records were retrospectively reviewed. Kaplan–Meier method was used to determine the 5, 10 year overall survival (OS) rate and relapse free survival rate and Cox Regression test was used to assess the association between patient outcome and age at diagnosis, metastasis status at time of diagnosis, tumor size, nodal involvement and use of chemotherapy. Results: Of these 64 patients, median age at diagnosis was 68 years, majority of patients were white, 13 patients had family history of breast or ovarian cancer (20.3%), four patients tested positive for BRCA2 (6.25). Majority of patients presented painless breast lump. A total of 59 patients (92.2%) had invasive ductal carcinoma, and 31 patients (48.4%) had lymph node involvement at time of diagnosis. A total of 62 patients (96.8%) had M0 disease at time of diagnosis. About 97% of patients had estrogen receptor (ER) positive cancer. Most patients underwent mastectomy (87.5%), 35 patients (54.6%) received adjuvant radiation therapy, 19 patients (30%) received adjuvant chemotherapy and 96.7% of patients received adjuvant hormonal therapy. The median follow-up was 71.5 months (range 6–250 months), 5-year survival rate was 86.9% (95% CI: 74.5–93.6%), 5-year relapse free survival rate was 89.9% (95% CI: 77.4–95.7%) and 10-year survival rate was 58.1% (95% CI: 41.0–71.8%). The presence of distant metastasis at the time of initial diagnosis was the only factor associated with shorter OS (hazard ratio: 22.54, p < 0.0001). Conclusion: Majority of MBC patients present with palpable breast mass and the tumors are almost exclusively hormone receptor positive. Majority of patients present without distant metastasis and received surgical therapy; however, only a small subset of patients received breast conserving surgery for T1 tumor. Almost all patients received adjuvant hormonal therapy. OS and relapse free survival in our cohort is similar to historic reports in female breast cancer.

Artificial intelligence techniques for the diagnosis of disease continue to develop with rapid pace. This review article systematically determines incremental accuracy and other parameters of current methods, including sensitivity, specificity, positive predictive value and negative predictive value with regard to breast MRI as a screening tool for women under 50 years. Articles were included from the databases of health technology assessment agencies from 2000 to 2019, using various medical subject heading terms. A total of 23 eligible studies were included incorporating a total of 11,688 patients out of which two were multicentered, four were accuracy studies, seven were prospective studies and four were retrospective studies. MRI screening showed an adequate detection of invasive cancers, premalignant lesions and pre-invasive cancers, suggesting that MRI is a powerful surveillance tool to detect cancer in high-risk populations. These findings have indicated that MRI has particular sensitivity and specificity for the diagnosis of breast cancer. PROSPERO Registration Number: CRD42020158372.

Aim: In Canada, osteopathic medicine, a well-known branch of complementary/alternative medicine, has received minimal attention for pain management within oncology. Purpose: This review reports both the existing literature and patient experience surrounding the application of osteopathy as an effective treatment for pain in breast cancer patients. Results: Both the literature and this case study support, to some degree, the benefits of osteopathy as pain management for breast cancer patients. Conclusion: Due to contradictory reported findings, more studies would be required to make firm conclusions, especially within a Canadian context. However, a lack of standardization of osteopathic procedures and collaboration between osteopaths and traditional healthcare professionals are challenges in including osteopathy as a standard service offered to breast cancer patients.

Male breast cancers account for 1% of worldwide breast malignancies and are on the rise. Sri Lankan accounts are limited due to lack of healthcare seeking behavior among men. A 63-year-old male presented with a right sided hard breast lump and a Breast Imaging Reporting and Database System score 5 lesion with axillary lymph node metastasis was observed on ultrasonography. Core biopsy revealed invasive ductal breast cancer. Tumor staging revealed a T2N1M0 cancer for which mastectomy with level 2 axillary clearance was performed followed by radiotherapy and systemic therapy. Male breast cancer even though similar to female breast cancers have important distinctions with regard to molecular biology, lymphatic metastasis and age of presentation. Management; however, still relies on studies based on the female counterpart.