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Cancers
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Breast Cancer: Prevention and Treatment
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Breast Cancer: Prevention and Treatment

A special issue of Cancers (ISSN 2072-6694). This special issue belongs to the section "Cancer Epidemiology and Prevention".

Deadline for manuscript submissions: closed (1 December 2023) | Viewed by 13814

Special Issue Editors

Dr. Elisabetta Munzone

E-Mail Website
Guest Editor
Istituto Europeo di Oncologia, Milan, Italy
Interests: breast cancer
Dr. Carmen Criscitiello

E-Mail Website
Guest Editor
New Drugs and Early Drug Development for Innovative Therapies Division, IEO, European Institute of Oncology IRCCS, 20141 Milan, Italy
Interests: breast cancer; new drugs; clinical trials; translational research; immunotherapy
Special Issues, Collections and Topics in MDPI journals
Dr. Paola Zagami

E-Mail Website
Guest Editor
Department of Oncology and Hematology, University of Milano, Milan, Italy
Interests: breast cancer

Special Issue Information

Dear Colleagues,

Breast cancer (BC) is the most common tumor among women worldwide. The introduction of well-defined times and methods of screening contributed to a decline in BC mortality rates in high-resource countries. Moreover, in recent years, many efforts have been focused on the study of contemporaneous risk factors, early detection modalities, and novel effective treatments.

The new Special Issue for the journal Cancers, titled “Breast Cancer: Prevention and Treatment”, will focus on both primary and secondary prevention strategies, as well as the different available treatment options. Specifically, the impact of lifestyle, including diet, physical activity, or tobacco use, will be addressed as well as the risk to harbor genetic mutations for BC predisposition and the indication to genetic testing. Moreover, the use of systemic treatment will be argued with a specific focus on the last approved and the ongoing-investigated therapies, together with the recommendations and prevention strategies of specific sub-populations, such us those at increased risk of BC development due to germline mutations. Finally, there will be a focus on (neo)adjuvant trials, which have recently gained increasing attention due to their ability to directly evaluate treatment effects on tumors and their unique translational research potential. Similar to technologies advances from the pre-genomic to the post-genomic era, (neo)adjuvant treatments enable the identification of better predictive biomarkers with personalized treatment strategies, including the post-neoadjuvant/adjuvant setting, particularly in patients with high-risk disease.

Dr. Elisabetta Munzone
Dr. Carmen Criscitiello
Dr. Paola Zagami
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Cancers is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2900 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • breast cancer
  • prevention
  • diet
  • neo and adjuvant treatment
  • genetic predisposition
  • high risk

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Published Papers (6 papers)

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Research

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9 pages, 851 KiB  
Article
The Impact of the COVID-19 Pandemic on Adherence to Endocrine Therapy for Breast Cancer in Catalonia (Spain)
by Aurea Navarro-Sabate, Rebeca Font, Fina Martínez-Soler, Judit Solà, Avelina Tortosa, Josepa Ribes, Llúcia Benito-Aracil, Josep Alfons Espinas and Josep Maria Borras
Cancers 2024, 16(2), 426; https://doi.org/10.3390/cancers16020426 - 19 Jan 2024
Viewed by 1186
Abstract
Purpose. To assess the impact of the COVID-19 pandemic on adherence to oral endocrine therapy in patients diagnosed with breast cancer in the public healthcare system in Catalonia (Spain). Methods. Retrospective cohort study in patients starting endocrine therapy from 2017 to [...] Read more.
Purpose. To assess the impact of the COVID-19 pandemic on adherence to oral endocrine therapy in patients diagnosed with breast cancer in the public healthcare system in Catalonia (Spain). Methods. Retrospective cohort study in patients starting endocrine therapy from 2017 to 2021. Adherence was measured during the first year of treatment, and the impact of the pandemic was calculated according to the calendar year and whether the first year of treatment included the peak period of the pandemic in our setting (March–September 2020). Analyses were performed using a chi-square test and multivariable logistic regression, with results stratified by year, age group, and drug type. Results. Mean overall adherence during the first year of treatment was 89.6% from 2017 to 2021. In contrast, the patients who started treatment in 2019 and 2020 and whose treatment included the peak pandemic period presented an adherence of 87.0% and 86.5%, respectively. Young age and tamoxifen or combination therapy were predictors of low adherence. An increase in neoadjuvant therapy was also observed in 2020. Conclusions. The COVID-19 pandemic had only a modest impact on adherence to endocrine therapy (≈3%), despite the enormous disruptions for patients, the healthcare system in general, and cancer care in particular that were occurring in that period. Full article
(This article belongs to the Special Issue Breast Cancer: Prevention and Treatment)
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11 pages, 1188 KiB  
Article
Comparing Prognosis for BRCA1, BRCA2, and Non-BRCA Breast Cancer
by Pedro Antunes Meireles, Sofia Fragoso, Teresa Duarte, Sidónia Santos, Catarina Bexiga, Priscila Nejo, Ana Luís, Beatriz Mira, Isália Miguel, Paula Rodrigues and Fátima Vaz
Cancers 2023, 15(23), 5699; https://doi.org/10.3390/cancers15235699 - 3 Dec 2023
Cited by 4 | Viewed by 2852
Abstract
Background: Germline pathogenic variants (PV) in BRCA1 and BRCA2 genes, which account for 20% of familial breast cancer (BC) cases, are highly penetrant and are associated with Hereditary Breast/Ovarian Cancer Syndrome. Previous studies, mostly including higher numbers of BRCA1 BC patients, yielded conflicting [...] Read more.
Background: Germline pathogenic variants (PV) in BRCA1 and BRCA2 genes, which account for 20% of familial breast cancer (BC) cases, are highly penetrant and are associated with Hereditary Breast/Ovarian Cancer Syndrome. Previous studies, mostly including higher numbers of BRCA1 BC patients, yielded conflicting results regarding BRCA1/2 BC outcomes. In the Portuguese population, BRCA2 BC is diagnosed more frequently than BRCA1 BC. We aimed to compare clinicopathological characteristics and prognosis between BC patients with BRCA1 and BRCA2 mutations and a control group without germline PV (BRCA-wt). Furthermore, we explored the frequency and outcomes of risk-reducing surgeries in BRCA-mutated patients. Methods: Prospective follow-up was proposed for patients with a diagnosed BRCA1/2 PV. For this study, a matched control group (by age at diagnosis, by decade, and by stage at diagnosis) included BC patients without germline PV. We compared overall survival (OS) and invasive disease-free survival (iDFS) within the three groups, and the use of risk-reducing surgeries among the BRCA cohort. Results: For a mean follow-up time of 113.0 months, BRCA-wt patients showed longer time to recurrence (p = 0.002) and longer OS (p < 0.001). Among patients with BRCA mutations, no statistical differences were found, although patients with BRCA2 BC had longer iDFS and OS. Uptake of risk-reducing surgeries (contralateral prophylactic mastectomy and salpingo-oophorectomy) were negative predictors of invasive disease and death, respectively. Conclusions: Testing positive for a BRCA PV is associated with a higher risk of relapse and death in patients with BC in the Portuguese population. Risk-reducing mastectomy and salpingo-oophorectomy were associated with lower incidence of relapse and longer median iDFS and OS, respectively. Full article
(This article belongs to the Special Issue Breast Cancer: Prevention and Treatment)
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13 pages, 752 KiB  
Article
Decision Tree Analyses for Prediction of QoL over a One-Year Period in Breast Cancer Patients: An Added Value of Patient-Reported Outcomes
by Magdalena Anna Lazarewicz, Dorota Wlodarczyk and Randi Johansen Reidunsdatter
Cancers 2023, 15(9), 2474; https://doi.org/10.3390/cancers15092474 - 26 Apr 2023
Cited by 1 | Viewed by 1624
Abstract
Despite the current shift in medicine towards patient-centered care, clinicians rarely utilize patient-reported outcomes (PROs) in everyday practice. We examined the predictors of quality- of-life (QoL) trajectories in breast cancer (BC) patients during the first year after primary treatment. A total of 185 [...] Read more.
Despite the current shift in medicine towards patient-centered care, clinicians rarely utilize patient-reported outcomes (PROs) in everyday practice. We examined the predictors of quality- of-life (QoL) trajectories in breast cancer (BC) patients during the first year after primary treatment. A total of 185 BC patients referred for postoperative radiotherapy (RT) filled in the EORTC QLQ-C30 Questionnaire assessing global QoL, functioning and cancer-related symptoms before starting RT; directly after RT; and 3, 6 and 12 months after RT. We used decision tree analyses to examine which baseline factors best allowed for predicting the one-year trajectory of the global QoL after BC treatment. We tested two models: ‘basic’, including medical and sociodemographic characteristics, and ‘enriched’, additionally including PROs. We recognized three distinct trajectories of global QoL: ‘high’, ‘U-shape’ and ‘low’. Of the two compared models, the ‘enriched’ model allowed for a more accurate prediction of a given QoL trajectory, with all indicators of model validation being better. In this model, baseline global QoL and functioning measures were the key discriminators of QoL trajectory. Taking PROs into account increases the accuracy of the prediction model. Collecting this information in the clinical interview is recommended, especially for patients with lower QoL. Full article
(This article belongs to the Special Issue Breast Cancer: Prevention and Treatment)
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Review

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8 pages, 2017 KiB  
Review
Breast Cancer in the Tissue of the Contralateral Breast Reduction
by Zoë M. A. Kuijlaars, Nadine S. Hillberg, Loes Kooreman, Carmen A. H. Severens Rijvers and Shan Shan Qiu
Cancers 2024, 16(3), 497; https://doi.org/10.3390/cancers16030497 - 24 Jan 2024
Viewed by 1315
Abstract
Breast cancer is the most prevalent malignancy among women worldwide, and the increasing number of survivors is due to advances in early diagnosis and treatment efficacy. Consequently, the risk of developing contralateral breast cancer (CBC) among these survivors has become a concern. While [...] Read more.
Breast cancer is the most prevalent malignancy among women worldwide, and the increasing number of survivors is due to advances in early diagnosis and treatment efficacy. Consequently, the risk of developing contralateral breast cancer (CBC) among these survivors has become a concern. While surgical intervention with lumpectomy is a widely used primary approach for breast cancer, post-operative breast asymmetry is a potential concern. Many women opt for symmetrizing reduction procedures to improve aesthetic outcomes and quality of life. However, despite careful radiological screening, there is a chance of accidentally finding CBC. To address this, tissue excised during symmetrizing surgery is examined pathologically. In some cases, CBC or in situ lesions have been incidentally discovered in these specimens, prompting a need for a more thorough examination. Resection in pieces and the absence of surgical marking and pathological inking of the margin have made it challenging to precisely identify tumor location and assess tumor size and margin status, hampering adjuvant treatment decisions. A new protocol introduced in July 2022 aims to enhance the precision of CBC diagnosis, allowing for tailored treatment plans, including re-excision, systemic adjuvant therapy, or radiation therapy. Full article
(This article belongs to the Special Issue Breast Cancer: Prevention and Treatment)
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17 pages, 1372 KiB  
Review
Antidiabetic Drugs in Breast Cancer Patients
by Wojciech Garczorz, Agnieszka Kosowska and Tomasz Francuz
Cancers 2024, 16(2), 299; https://doi.org/10.3390/cancers16020299 - 10 Jan 2024
Cited by 1 | Viewed by 2408
Abstract
Diabetes is one of the leading chronic conditions worldwide, and breast cancer is the most prevalent cancer in women worldwide. The linkage between diabetes and its ability to increase the risk of breast cancer should always be analyzed in patients. This review focuses [...] Read more.
Diabetes is one of the leading chronic conditions worldwide, and breast cancer is the most prevalent cancer in women worldwide. The linkage between diabetes and its ability to increase the risk of breast cancer should always be analyzed in patients. This review focuses on the impact of antihyperglycemic therapy in breast cancer patients. Patients with diabetes have a higher risk of developing cancer than the general population. Moreover, diabetes patients have a higher incidence and mortality of breast cancer. In this review, we describe the influence of antidiabetic drugs from insulin and metformin to the current and emerging therapies, incretins and SGLT-2 inhibitors, on breast cancer prognosis. We also emphasize the role of obesity and the metastasis process in breast cancer patients who are treated with antidiabetic drugs. Full article
(This article belongs to the Special Issue Breast Cancer: Prevention and Treatment)
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27 pages, 2636 KiB  
Review
Systemic and Local Strategies for Primary Prevention of Breast Cancer
by Erin K. Zaluzec and Lorenzo F. Sempere
Cancers 2024, 16(2), 248; https://doi.org/10.3390/cancers16020248 - 5 Jan 2024
Cited by 5 | Viewed by 3538
Abstract
One in eight women will develop breast cancer in the US. For women with moderate (15–20%) to average (12.5%) risk of breast cancer, there are few options available for risk reduction. For high-risk (>20%) women, such as BRCA mutation carriers, primary prevention strategies [...] Read more.
One in eight women will develop breast cancer in the US. For women with moderate (15–20%) to average (12.5%) risk of breast cancer, there are few options available for risk reduction. For high-risk (>20%) women, such as BRCA mutation carriers, primary prevention strategies are limited to evidence-based surgical removal of breasts and/or ovaries and anti-estrogen treatment. Despite their effectiveness in risk reduction, not many high-risk individuals opt for surgical or hormonal interventions due to severe side effects and potentially life-changing outcomes as key deterrents. Thus, better communication about the benefits of existing strategies and the development of new strategies with minimal side effects are needed to offer women adequate risk-reducing interventions. We extensively review and discuss innovative investigational strategies for primary prevention. Most of these investigational strategies are at the pre-clinical stage, but some are already being evaluated in clinical trials and others are expected to lead to first-in-human clinical trials within 5 years. Likely, these strategies would be initially tested in high-risk individuals but may be applicable to lower-risk women, if shown to decrease risk at a similar rate to existing strategies, but with minimal side effects. Full article
(This article belongs to the Special Issue Breast Cancer: Prevention and Treatment)
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