Breast Cancer, The official journal of the Japanese Breast Cancer Society, Breast Cancer publishes articles that contribute to progress in the field, in basic or translational research and also in clinical research. It develops a new focus and new perspectives for all who are concerned with breast cancer.Breast Cancer presents original articles describing clinical, epidemiological studies and laboratory investigations regarding breast cancer and related diseases. It features editorials, review articles, original articles, case reports, and short papers. The journal provides the best of up-to-date information on breast cancer, presenting readers with high-impact, original work focusing on pivotal issues.

Correction to: Chemotherapy and targeted therapy for breast cancer patients with hepatitis C virus infection The online version of the original article can be found.

Younger breast cancer patients under the age of 35 might have a better disease-free survival if they received ovarian function suppression more than 3 years

Could sentinel lymph node biopsy be exempted for ductal carcinoma in situ after mastectomy?

Evaluation of health-related quality of life via the Computer-Based Health Evaluation System (CHES) for Japanese metastatic breast cancer patients: a single-center pilot study Abstract Background The main purposes of metastatic breast cancer (MBC) treatment are to prolong survival and maintain health-related quality of life (HRQOL). Compliance with the HRQOL assessment can be poor, particularly among patients who receive long-term treatment. One possible solution to overcoming this problem is to engage in real-time home monitoring by having patients report outcomes on their personal electronic devices. The objective of this study was to investigate compliance with HRQOL monitoring from home among MBC patients using the Computer-Based Health Evaluation System (CHES) to collect patient data. Methods Sixteen MBC patients who received outpatient chemotherapy or endocrine therapy, both with and without targeted therapy, were recruited. One eligibility criterion was the availability of a personal electronic device with access to the Internet. Patients were asked to enter HRQOL ratings from their personal electronic devices via CHES once every week for 12 weeks. The European Organization for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire-Core 30 (QLQ C30) was used to evaluate HRQOL. The outcome examined was the questionnaire collection rate. Results Six patients (37.5%) were treated with chemotherapy only, one (6.2%) with endocrine therapy only, three (18.8%) with a combination of chemotherapy and targeted therapy, and six (37.5%) with a combination of endocrine and targeted therapy. Median questionnaire collection rate for the total of 12 weeks was 84.6% (interquartile range 44.3–100). The reasons for missing data were worsening of disease, forgetting, and device malfunction. Conclusions Compliance with electronic HRQOL data collection in this cohort was acceptable, considering the general ideal collection rate of 70–80%. We are conducting a prospective study to determine whether the use of CHES to input electronic real-time feedback of HRQOL ratings improves patients' overall HRQOL.

The decision to perform or omit sentinel lymph node biopsy during mastectomy for ductal carcinoma in situ should be tailored in accordance with preoperative findings

Chemotherapy and targeted therapy for breast cancer patients with hepatitis C virus infection Abstract Background Hepatitis C virus infection (HCV) is a major health problem in Egypt. Breast cancer is the most common cancer among Egyptian women. Considering that both diseases are frequent in the Egyptian population, it is likely that many women are affected by both. Purpose To evaluate patient safety and applicability of chemotherapy in chronic hepatitis C virus-infected patients with breast cancer. Subjects and methods We performed retrospective survey of 58 Egyptian patients diagnosed with both diseases. We retrospectively investigated the baseline patient and tumor characteristics, the toxicities of chemotherapy, and the changes in HCV viral load before and after chemotherapy, in addition to treatment received for HCV infection. Results Forty-four (75.9%) out of the 58 patients received chemotherapy with or without trastuzumab and one patient received lapatinib. We reported 2 patients who had HCV viral reactivation. Treatment with trastuzumab or Lapatinib was not associated with elevation in liver enzymes or change in HCV RNA viral load. Treatment discontinuation occurred in 31.8% (14/44) of patients due to complications. Dose reductions and/or dose delays were common (27.2%). Elevated liver enzymes were developed in 20 out of 44 (45.5%) patients who received chemotherapy. Three patients received antiviral treatment concomitant with chemotherapy with no significant complications. Conclusions Greater attention should be paid to the possibility of complications including HCV reactivation, fulminant hepatitis, and interrupted chemotherapy treatments in breast cancer patients with chronic HCV infection receiving immunosuppressive drugs. Close monitoring of patients with breast cancer and HCV infection should be done

Validation of an information–motivation–behavioral skills model of upper limb functional exercise adherence among Chinese postoperative patients with breast cancer Abstract Background The adherence to postoperative upper limb functional exercise in breast cancer (BC) patients is poor which can lead to adverse health outcomes. Effective intervention content to improve adherence is still unclear. The information–motivation–behavioral skills (IMB) model is a theoretical model that has been widely used to promote health behavior in many disease populations and may, therefore, help to explain and promote adherence to functional exercise. In this study, we validated the IMB model in a sample of postoperative BC patients. Methods A cross-sectional study of 165 postoperative patients with BC was performed in a hospital. We collected information on demographics, functional exercise knowledge (information), personal and social motivation (motivation), objective skills and self-efficacy (behavioral skills), and functional exercise adherence (behavior). Measured variable path analyses were applied for the IMB framework. Results The IMB elements explained 37.9% of the variance in adherence. As predicted, behavioral skills had a direct effect on adherence (β = 0.509; P < 0.05) and mediated the effects of knowledge (indirect effect 0.092, P < 0.05) and motivation (indirect effect 0.251, P < 0.05) on adherence. Conclusions Behavioral skills have a direct effect on functional exercise adherence and a mediating effect on the influence of knowledge and motivation on adherence. Thus, these factors represent key determinants of exercise adherence. The IMB model could be applied to the upper limb exercise adherence of postoperative BC patients. These findings indicate that the promotion of exercise adherence interventions may benefit from targeting patients' exercise adherence-related knowledge, motivation, and behavioral skills.

Does breast cancer growth rate really depend on tumor subtype? Measurement of tumor doubling time using serial ultrasonography between diagnosis and surgery Abstract Background Breast cancer growth is generally expected to differ between tumor subtypes. We aimed to evaluate tumor doubling time (DT) using ultrasonography and verify whether each tumor subtype has a unique DT. Methods This retrospective study included 265 patients with invasive breast cancer who received serial ultrasonography between diagnosis and surgery. Tumor diameters were measured in three directions and DTs were calculated according to an exponential growth model using the volume change during serial ultrasonography. We investigated the relationships between DT, tumor subtype, and histopathological factors. Results Volumes did not change in 95 (36%) of 265 tumors and increased in 170 (64%) tumors during serial ultrasonography (mean interval, 56.9 days). The mean volume increases of all tumors and volume-increased tumors were 22.1% and 34.5%, respectively. Triple-negative tumors had greater volume increases (40% vs. 20%, p = 0.001) and shorter DT (124 vs. 185 days, p = 0.027) than estrogen receptor (ER)+/human epidermal growth factor receptor 2 (HER2)– tumors. Volume-increased tumors had higher Ki-67 indices than those of volume-stable tumors in ER+/HER2− (p = 0.002) and ER+/HER2+ tumors (p = 0.011) and higher histological grades in all tumors except triple-negative tumors (p < 0.001). Triple-negative tumors with DTs < 90 days (short-DT) showed higher Ki-67 indices than those with DTs > 90 days (long-DT) (p = 0.008). In ER+/HER2− tumors, histological grades were higher for short-DT than for long-DT tumors (p = 0.022). Conclusion Differences in tumor DT depending on breast cancer subtype, Ki-67 index, and histological grade were confirmed using serial ultrasonography even during preoperative short interval.

Oligometastatic breast cancer Abstract Metastatic breast cancer (MBC) is considered as incurable. The group of patients with oligometastatic disease (a few metastatic lesions and organs involved) apparently have better prognosis. It is claimed that, these patients could be treated with curative intent, and multidisciplinary aggressive approach should be considered. Despite the lack of strong data it is increasingly accepted in clinical practice. Currently, the appropriate candidate would be young woman with good performance status, low tumour burden with long disease-free interval. Because for them with already favorable nature of their disease, aggressive treatment has greater chances to improve survivals. Local ablative treatment (radiotherapy/surgery) has a crucial role in this setting. Available mainly from retrospective in nature long-term results are encouraging but need confirmation in prospective randomized studies. In this review, I discuss the definition of oligometastatic disease, its nature, currently available data and ongoing prospective randomized trials dedicated to oligometastatic breast cancer patients.

Expression of the RAC1, RHOA and CXCR4 proteins and their interaction as risk factors for infiltration to the nipple areola complex in operable breast carcinoma Abstract Background Nipple areola complex (NAC) infiltration in operable breast carcinoma (OBC) is associated with local recurrence. NAC infiltration in OBC suggests that RAC1, RHOA and CXCR4 proteins are risk factors for migration and infiltration of OBC to NAC. This study aims to analyze the expression and interactions of these proteins as risk factors for NAC infiltration in OBC. Materials and methods This is an analytic observational cross-sectional study coupled with a categorical comparative study in each 40 subjects of OBC with and without NAC infiltration. The immunohistochemistry performed with a cut-off point based on the result of a receiver operating characteristics (ROC). Results RAC1, p < 0.001 with POR 5.76, 95% CI: 2.06–16.08; RHOA, p < 0.001 with POR 7.00, 95% CI: 2.28–21.53; and CXCR4, p = 0.001 with POR 6.33, 95% CI 2.06–19.49. There was an interaction between RAC1 and RHOA (p < 0.001 with POR 17.14, 95% CI: 3.07-125.66); between RAC1 and CXCR4 (p < 0.001 with POR 30.93, 95% CI 3.62–686.89); between RHOA and CXCR4 (p < 0.001 with POR 10.21, 95% CI 2.19–54.17); and between the RAC1, RHOA and CXCR4 proteins (p < 0.001 with POR = 23.69, 95% CI 2.51–544.86). Conclusion We conclude that the expression of the RAC1, RHOA, and CXCR4 proteins and their interactions play a role as risk factors of NAC infiltration.