Cancer Research and Treatment

Original Articles

Impact of High Lymph Node Burden on Brain Metastases in Patients Who Achieved Pathological Complete Response after Neoadjuvant Chemotherapy in HER2-Positive Breast Cancer: Seung Ah Lee, Ki Jo Kim, Do Youn Woen, Su Min Lee, Kawon Oh, Cho Eun Lee, Woong Ki Park, Ji Won Yoo, Dong Seung Shin, Jai Min Ryu, Se Kyung Lee, Byung Joo Chae, Jonghan Yu, Seok Won Kim, Seok Jin Nam, Ji-Yeon Kim, Yeon Hee Park, Eun Young Ko, Eun Sook Ko, Jeong Eon Lee; Received February 24, 2025 Accepted July 6, 2025 Published online July 8, 2025; DOI: https://doi.org/10.4143/crt.2025.219 [Epub ahead of print]

Abstract PDF Supplementary Material PubReader ePub: Purpose
This study aims to investigate the clinical characteristics, outcomes, and predictors of brain metastases in human epidermal growth factor receptor 2 (HER2)–positive advanced breast cancer patients who achieved pathological complete response (pCR) following neoadjuvant chemotherapy (NAC). This research seeks to inform surveillance strategies and optimize management for high-risk subgroups.
Materials and Methods
A retrospective analysis of 1,757 patients (2008-2022) classified them into pCR (n=914) and non-pCR (n=843) groups post-NAC. Collected data included demographics, clinical features, and metastasis parameters. Survival outcomes and brain metastasis predictors were assessed using Kaplan-Meier curves, Cox models, and logistic regression.
Results
Among pCR patients, brain metastases accounted for 54.2% of distant metastases, significantly affecting overall survival (p < 0.001). Median distant metastasis-free survival was shorter for brain metastases (13.4 months) compared to extracranial metastases (31.1 months) in the pCR group (p=0.005). Positive supraclavicular node (SCN) fine needle aspiration (FNA) and clinical N3 (cN3) category were the strongest predictors of brain metastases (SCN FNA: odds ratio [OR], 12.9; p < 0.001; cN3: OR, 12.1; p < 0.001). Multivariable Cox regression analysis revealed that positive SCN FNA and cN3 category were strong predictors of reduced distant metastasis-free survival (SCN FNA: hazard ratio, 2.5; 95% confidence interval [CI], 1.3 to 3.6; p < 0.001; cN3: hazard ratio, 11.3; 95% CI, 4.9 to 33.0; p < 0.001).
Conclusion
This study highlights the challenges of brain metastases in HER2-positive pCR patients, emphasizing the need for tailored therapeutic strategies and enhanced surveillance. High lymph node burden prior to NAC is a significant factor in risk assessment. Therefore, it may be advisable to recommend post-surgery surveillance for high-risk patients.

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Breast cancer

Endoxifen Concentration Is Associated with Recurrence-Free Survival in Hormone-Sensitive Breast Cancer Patients: Beomki Lee, Seok Jin Nam, Seok Won Kim, Jonghan Yu, Byung-Joo Chae, Se Kyung Lee, Jai Min Ryu, Jeong Eon Lee, Soo-Youn Lee; Cancer Res Treat. 2025;57(1):140-149. Published online June 18, 2024; DOI: https://doi.org/10.4143/crt.2023.1285

Abstract PDF PubReader ePub: Purpose
The metabolism of tamoxifen is influenced by various cytochrome p450 enzymes, including CYP2D6 and CYP2C19, leading to variations in the levels of endoxifen, even with the same tamoxifen dose. However, the clinical significance of endoxifen for the prognosis of breast cancer patients remains controversial. This study aimed to elucidate the relevance of endoxifen level to recurrence-free survival censored with tamoxifen discontinuation (RFSt), representing the RFS for tamoxifen itself, of breast cancer patients and determine a suitable cutoff for prognostication.
Materials and Methods
The study included 478 breast cancer patients. Tamoxifen and its metabolites, including endoxifen, were measured using liquid chromatography-tandem mass spectrometry. An optimal cutoff was determined with maximally selected rank statistics. Survival analysis and Cox regression were conducted based on this cutoff.
Results
An endoxifen level of 21.00 ng/mL was the optimal cutoff for prognostication. Survival analysis revealed a statistically significant difference in RFSt between the low endoxifen group (≤ 21.00 ng/mL) and the high endoxifen group (> 21.00 ng/mL) (log-rank test, p=0.032). The 10-year probability of RFSt was 83.2% (95% confidence interval [CI], 77.0 to 89.9) and 88.3% (95% CI, 83.3 to 93.5) in the low and high endoxifen groups, respectively. Multivariable Cox proportional hazards regression indicated endoxifen concentration as a significant factor associated with prognosis.
Conclusion
Endoxifen could serve as a marker for appropriate tamoxifen treatment with a cutoff of 21.00 ng/mL. Based on this cutoff, therapeutic drug monitoring would benefit patients displaying suboptimal endoxifen concentrations.

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Impact of Social Support during Diagnosis and Treatment on Disease Progression in Young Patients with Breast Cancer: A Prospective Cohort Study: Danbee Kang, Seri Park, Hyo Jung Kim, Seok Won Kim, Jeong Eon Lee, Jonghan Yu, Se Kyung Lee, Ji-Yeon Kim, Seok Jin Nam, Juhee Cho, Yeon Hee Park; Cancer Res Treat. 2024;56(1):125-133. Published online September 4, 2023; DOI: https://doi.org/10.4143/crt.2023.673

Abstract PDF PubReader ePub: Purpose
We evaluated the association between changes in social support after cancer treatment and recurrence-free survival (RFS) in such patients using a prospective cohort study.
Materials and Methods
Data were obtained from a prospective cohort study (NCT03131089) conducted at Samsung Medical Center (2013-2021). The primary outcome measure was RFS. Social support was measured using the social and family well-being (SFWB) domain of the Functional Assessment of Cancer Therapy-General. We calculated the changes in SFWB scores before and during treatment and the hazard ratio for RFS by comparing such changes.
Results
The mean±standard deviation (SD) age of the patients was 35±3.9 years, and 71.5% and 64.8% of the patients were married and had children, respectively. The mean±SD SFWB score at baseline was 20.5±5.0 out of 26. After cancer treatment, 35.9%, 10.3%, and 53.8% of the participants had increasing, unchanged, and decreasing SFWB scores, respectively. The decreasing SFWB score group had a higher risk of mortality or recurrence than the increasing group. Risk factors for the decreasing score were the presence of children during diagnosis.
Conclusion
In this cohort, changes in social support after treatment were associated with RFS in young patients with breast cancer. Health professionals should develop family interventions to help them receive proper social support.

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Real World Evidence of Neoadjuvant Docetaxel/Carboplatin/Trastuzumab/Pertuzumab (TCHP) in Patients with HER2-Positive Early or Locally Advanced Breast Cancer: A Single-Institutional Clinical Experience: Ji-Yeon Kim, Seok Jin Nam, Jeong Eon Lee, Jonghan Yu, Byung Joo Chae, Se Kyung Lee, Jai Min Ryu, Jin Seok Ahn, Young-Hyuck Im, Seok Won Kim, Yeon Hee Park; Cancer Res Treat. 2022;54(4):1091-1098. Published online January 10, 2022; DOI: https://doi.org/10.4143/crt.2021.901

Abstract PDF Supplementary Material PubReader ePub

Purpose
Docetaxel/carboplatin/trastuzumab/pertuzumab (TCHP) regimen is frequently used to treat early and locally advanced human epidermal growth factor receptor 2 (HER2)–positive breast cancer (BC) in neoadjuvant setting. However, large-scaled real-world evidence did not exist.
Materials and Methods
We retrospectively reviewed medical records of patients with early or locally advanced HER2-positive BC who underwent neoadjuvant TCHP followed by curative surgery at Samsung Medical Center between January 2016 and August 2020.
Results
Of 447 patients, 316 (70.7%) received breast-conserving surgery and 131 (29.3%) received total mastectomy. In terms of neoadjuvant chemotherapy response, pathologic complete response (pCR) and residual cancer burden (RCB) score were analyzed. The rate of pCR was 64% a class of RCB 0 was observed in 65% of cases, RCB class I in 12%, RCB class II in 14%, and RCB class III in 2%. The 3-year event-free survival rate was 90.6%, BC with pCR occurred in 92.8%, and BC with non-pCR in 86.3% (p=0.016). In terms of distant metastasis, the 3-year distant recurrence-free survival rate was 93.5%; BC with pCR occurred in 95.9% and BC with non-pCR in 89.2% (p=0.013). Mucositis (85.2%), pain (83.2%), and diarrhea (70.5%) were the most common non-hematologic adverse events. In terms of hematologic adverse events, anemia (89.9%) was the most commonly observed adverse events followed by thrombocytopenia (29.8%).
Conclusion
Neoadjuvant TCHP therapy had a pCR rate of 64% and a 3-year event-free survival of 90% in real world experience. In terms of toxicity profile, anemia was frequently observed and adequate management including occasional transfusion was required.

Citations

Citations to this article as recorded by

Efficacy, safety, and biomarkers of neoadjuvant trastuzumab and pertuzumab combined with chemotherapy in Chinese patients with HER2-positive breast cancer: a multicenter retrospective cohort study
Xiaowei Qi, Hong Hu, Pengfei Qiu, Wenlin Chen, Xiaochun Wang, Qiyun Shi, Yan Xu, Shu Liu, Yanman Fang, Taolang Li, Jia Ming, Sihai Zhou, Fan Chai, Yueyang Liang, Yuanming Fan, Peng Tang, Li Chen, Shushu Wang, Jun Jiang, Mengyuan Wang, Yi Zhang, Jianyun Ni
International Journal of Surgery.2026; 112(1): 1318. CrossRef
Systemic Treatment for Patients with Early-Stage Breast Cancer
Hee Kyung Ahn
The Korean Journal of Medicine.2026; 101(2): 70. CrossRef
Bridging Clinical Trials to Real-World Clinical Practice: TCHP Neoadjuvant Therapy Outcomes in HER2-Positive Breast Cancer
Baha Sharaf, Alaa Seif, Hira Bani Hani, Maha Alhasan, Rnad Khader, Maram Al-Yag'oub, Ameed Ghanem, Jinan Bani Ata, Batool Ajlouni, Qutaiba Jawarneh, Adel Jaffal, Faris Tamimi, Sharif Jehad, Haneen Al-Abdallat, Osama Mahafdah, Hikmat Abdel-razeq
Breast Cancer: Targets and Therapy.2026; Volume 18: 1. CrossRef
Decrease in Calcifications After Neoadjuvant Treatment Predicts Invasive Tumor Response but Not Complete DCIS Eradication: Systematic Review and Meta-Analysis
Noam Weiner, Yaron Niv, Eran Sharon
Clinical Breast Cancer.2025; 25(7): e990. CrossRef
Comparison of T-DM1 and trastuzumab-pertuzumab in HER2-positive breast cancer patients with residual disease after neoadjuvant therapy: a retrospective study
Junxiao Wang, Yushuai Yu, Qisheng Lin, Xin Wang
World Journal of Surgical Oncology.2025;[Epub] CrossRef
Pertuzumab/Docetaxel/Carboplatin/Trastuzumab Regimen in Human Epidermal Growth Factor Receptor 2–Positive Early, Locally Advanced, and Oligometastatic Breast Cancer: Real-World Outcomes From India
Ajay Gogia, Atul Batra, Ashutosh Mishra, Kamal Kataria, Surendra K. Saini, Sandeep Mathur, Chandra P. Prasad, Hari Krishna Raju Sagiraju
JCO Global Oncology.2025;[Epub] CrossRef
De-escalation of neoadjuvant taxane and carboplatin therapy in HER2-positive breast cancer with dual HER2 blockade: a multicenter real-world experience in China
Song Wu, Li Bian, Haibo Wang, Shaohua Zhang, Tao Wang, Zhigang Yu, Jianbin Li, Feng Li, Kun Wang, Zefei Jiang
World Journal of Surgical Oncology.2024;[Epub] CrossRef
Distinct ER and PR expression patterns significantly affect the clinical outcomes of early HER2-positive breast cancer: A real-world analysis of 871 patients treated with neoadjuvant therapy
Haizhu Chen, Xiujuan Gui, Ziwei Zhou, Fengxi Su, Chang Gong, Shunrong Li, Wei Wu, Nanyan Rao, Qiang Liu, Herui Yao
The Breast.2024; 75: 103733. CrossRef
Impact of adding pertuzumab to trastuzumab plus chemotherapy in neoadjuvant treatment of HER2 positive breast cancer patients: a multicenter real-life HER2PATH study
Ahmet Bilici, Omer Fatih Olmez, Muhammed Ali Kaplan, Berna Oksuzoglu, Ahmet Sezer, Nuri Karadurmus, Erdem Cubukcu, Mehmet Ali Nahit Sendur, Sercan Aksoy, Dilek Erdem, Gul Basaran, Burcu Cakar, Abdallah T. M. Shbair, Cagatay Arslan, Ahmet Taner Sumbul, Sem
Acta Oncologica.2023; 62(4): 381. CrossRef
Pathologic Complete Response Achieved in Early-Stage HER2-Positive Breast Cancer After Neoadjuvant Therapy With Trastuzumab and Chemotherapy vs. Trastuzumab, Chemotherapy, and Pertuzumab: A Systematic Review and Meta-Analysis of Clinical Trials
Faizan Fazal, Muhammad Nauman Bashir, Maham Leeza Adil, Usama Tanveer, Mansoor Ahmed, Taha Zahid Chaudhry, Ali Ahmad Ijaz, Muhammad Haider
Cureus.2023;[Epub] CrossRef
Trends of axillary surgery in breast cancer patients with axillary lymph node metastasis: a comprehensive single-center retrospective study
Yeon Jin Kim, Hye Jin Kim, Soo Yeon Chung, Se Kyung Lee, Byung Joo Chae, Jonghan Yu, Jeong Eon Lee, Seok Won Kim, Seok Jin Nam, Jai Min Ryu
Annals of Surgical Treatment and Research.2023; 105(1): 10. CrossRef
Anthracyclines versus No Anthracyclines in the Neoadjuvant Strategy for HER2+ Breast Cancer: Real-World Evidence
Inês Soares de Pinho, Paulo Luz, Lucy Alves, Raquel Lopes-Brás, Vanessa Patel, Miguel Esperança-Martins, Lisa Gonçalves, Ritas Freitas, Diana Simão, Maria Roldán Galnares, Isabel Fernandes, Silvia Artacho Criado, Salvador Gamez Casado, Jose Baena Cañada,
Clinical Drug Investigation.2023; 43(9): 691. CrossRef
Benefit of postoperative regional nodal irradiation in patients receiving preoperative systemic therapy with docetaxel/carboplatin/trastuzumab/pertuzumab for HER2-positive breast cancer
Nalee Kim, Ji-Yeon Kim, Won Park, Won Kyung Cho, Tae Gyu Kim, Young-Hyuck Im, Jin Seok Ahn, Jeong Eon Lee, Seok Jin Nam, Seok Won Kim, Jonghan Yu, Byung Joo Chae, Sei Kyung Lee, Jai-Min Ryu, Yeon Hee Park, Haeyoung Kim
The Breast.2023; 72: 103594. CrossRef
Response Rate and Safety of a Neoadjuvant Pertuzumab, Atezolizumab, Docetaxel, and Trastuzumab Regimen for Patients With ERBB2-Positive Stage II/III Breast Cancer
Hee Kyung Ahn, Sung Hoon Sim, Koung Jin Suh, Min Hwan Kim, Jae Ho Jeong, Ji-Yeon Kim, Dae-Won Lee, Jin-Hee Ahn, Heejung Chae, Kyung-Hun Lee, Jee Hyun Kim, Keun Seok Lee, Joo Hyuk Sohn, Yoon-La Choi, Seock-Ah Im, Kyung Hae Jung, Yeon Hee Park
JAMA Oncology.2022; 8(9): 1271. CrossRef

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Clinicopathological Characterization of Double Heterozygosity for BRCA1 and BRCA2 Variants in Korean Breast Cancer Patients: Yoon Ju Bang, Won Kyung Kwon, Seok Jin Nam, Seok Won Kim, Byung-Joo Chae, Se Kyung Lee, Jai Min Ryu, Jong-Won Kim, Jonghan Yu, Jeong Eon Lee; Cancer Res Treat. 2022;54(3):827-833. Published online October 13, 2021; DOI: https://doi.org/10.4143/crt.2021.791

Abstract PDF Supplementary Material PubReader ePub

Purpose
Double heterozygosity (DH) for BRCA1 and BRCA2 variant is very rare with only a few cases reported, and most those in Caucasians. In this article, we present seven unrelated cases of DH for BRCA1/2 identified from a single institution in Korea, and describe the characteristics and phenotype of DH individuals compared to those with a single BRCA variant.
Materials and Methods
This study included 27,678 patients diagnosed with breast cancer and surgically treated at Samsung Medical Center (SMC) between January 2008 and June 2020. In total, 4,215 high-risk breast cancer patients were tested for the BRCA1/2 genes, and electronic medical records from 456 cases with pathogenic/likely pathogenic variants (PVs/LPVs) were reviewed.
Results
A younger mean age at diagnosis was associated with DH than a single variant of BRCA1/2. More triple-negative breast cancer (TNBC) and higher nuclear and histologic grade cancer occurred with DH than BRCA2 variant. All 7 cases of DH were unrelated, and their mutation combinations were different. There were no Ashkenazi founder variants detected.
Conclusion
We suggest that patients with DH for BRCA1/2 variants develop breast cancer at a younger age, but the histopathologic features are similar to those of BRCA1.

Citations

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Global prevalence and ethnic variation of pathogenic BRCA1/2 variants in breast cancer: a systematic review and meta-analysis
Najeeb Ullah Khan, Huijun Lei, Jinzhen Fu, Ruijiao Lei, Xukai Chen, Sana S. Alqarni, Tianhui Chen
Journal of Translational Medicine.2026;[Epub] CrossRef
Multi-locus inherited neoplasia alleles syndromes in cancer: implications for clinical practice
Jeanette Yuen, Siqin Zhou, Rebecca Caeser, Mallika Venkatramani, Diana Nur Bte Ishak, Shao-Tzu Li, Zewen Zhang, Jianbang Chiang, Sock Hoai Chan, Joanne Ngeow
European Journal of Human Genetics.2025; 33(3): 289. CrossRef
Carcinoma erysipeloides secondary to male breast cancer in a patient with BRCA1 and BRCA2 mutations: a clinical presentation and management
Ayushya Ajmani, Daniel W Witheiler, Dario Kivelevitch
BMJ Case Reports.2025; 18(4): e264429. CrossRef
Double heterozygosity for BRCA1 and BRCA2 in breast cancer: considerations in surveillance and cancer risk management
Nonoko Wakaki, Tatsunori Shimoi, Shogo Nakamoto, Yuichiro Kikawa, Aki Ito, Takayuki Iwamoto
BMJ Case Reports.2025; 18(4): e263687. CrossRef
Two-hit events occurred independently in bilateral breast cancers in a germline double heterozygous carrier for BRCA1 and BRCA2
Ryoko Semba, Hidetaka Eguchi, Mizuki Takatsu, Toko Hashizume, Hideaki Moteki, Kazuma Maeno, Fumi Murakami, Junichiro Watanabe, Goro Kutomi, Masami Arai
Breast Cancer.2025; 32(6): 1472. CrossRef
Prevalence of MUTYH Monoallelic Variants in Patients With Hereditary Cancer Using Multigene Panel Testing
Gemma Caliendo, Chiara Della Pepa, Alessia Mignano, Luisa Albanese, Luana Passariello, Anna Cozzolino, Francesca Iengo, Anna Maria Molinari, Laura Pesce, Maria Teresa Vietri
Cancer Medicine.2025;[Epub] CrossRef
Clinicopathological features of Chinese ovarian cancer patients with double heterozygosity for cancer-predisposed genes
Yikun Jin, Wenyan Wang, Manqi Wu, Yiming Fan, Tongxia Wang, Cuiyu Huang, Tong Gao, Yan Liu, Yuan Li, Qiyu Liu, Hongyan Guo
BMC Cancer.2025;[Epub] CrossRef
Case Report: Clinical impact of BRCA1 and BRIP1 vs. BRCA1 and BRCA2 germline double heterozygosity in ovarian cancer: a comparative case study
Limei Zheng, Qianyuan Zhu, Fenglan Zhang, Hao Qiu, Lan Qin, Jianhua Yang, Ming Qi
Frontiers in Oncology.2025;[Epub] CrossRef
Double Pathogenic or Likely Pathogenic Variants in Cancer Predisposition Genes in Hungarian Cancer Patients
Tímea Pócza, János Papp, Anikó Bozsik, Vince Kornél Grolmusz, Petra Nagy, Attila Patócs, Henriett Butz
International Journal of Molecular Sciences.2025; 26(17): 8390. CrossRef
Cost-effectiveness of talazoparib for patients with germline BRCA1/2 mutated HER2-negative advanced breast cancer in China and the US
Junjie Pan, Ning Ren, Lanqi Ren, YiBei Yang, Qiaoping Xu
Scientific Reports.2024;[Epub] CrossRef
Characteristics of Chinese breast cancer patients with double heterozygosity for BRCA1 and BRCA2 germline pathogenic variants
Song Wen, Meng Zhang, Jiuan Chen, Li Hu, Jie Sun, Lu Yao, Ye Xu, Juan Zhang, Yuntao Xie
Breast Cancer Research and Treatment.2024; 208(1): 155. CrossRef
Discovery of BRCA1/BRCA2 founder variants by haplotype analysis
Won Kyung Kwon, Hyeok-Jae Jang, Jeong Eon Lee, Yeon Hee Park, Jai Min Ryu, Jonghan Yu, Ja-Hyun Jang, Jong-Won Kim
Cancer Genetics.2022; 266-267: 19. CrossRef

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Validation of Korean Version of the COmprehensive Score for financial Toxicity (COST) Among Breast Cancer Survivors: Sungkeun Shim, Danbee Kang, Nayeon Kim, Gayeon Han, Jihyun Lim, Hyunsoo Kim, Jeonghyun Park, Mankyung Lee, Jeong Eon Lee, Seok Won Kim, Jonghan Yu, Byung Joo Chae, Jai Min Ryu, Seok Jin Nam, Se Kyung Lee, Juhee Cho; Cancer Res Treat. 2022;54(3):834-841. Published online October 13, 2021; DOI: https://doi.org/10.4143/crt.2021.784

Abstract PDF Supplementary Material PubReader ePub

Purpose
Little is known about the impact of financial toxicity in disease-free breast cancer survivors. We aim to validate the COmprehensive Score for financial Toxicity in Korean (COST-K) and evaluate financial toxicity among disease-free breast cancer survivors.
Materials and Methods
We conducted linguistic validation following a standardized methodology recommended by Functional Assessment of Chronic Illness Therapy multilingual translation (FACITtrans). For psychometric validation, we conducted a cross-sectional survey with 4,297 disease-free breast cancer survivors at a tertiary hospital in Seoul, Korea between November 2018 and April 2019. Survivors were asked to complete the COST-K and European Organization for Research and Treatment of Cancer Quality of Life Core 30 (EORTC QLQ-C30) questionnaires. The test-retest reliability, internal consistency, and validity of the COST-K were assessed using standard scale construction techniques.
Results
The COST-K demonstrated good internal consistency, with a Cronbach’s α of 0.81. The test-retest analysis revealed an intraclass correlation coefficient of 0.78. The COST-K had moderate correlation (r=–0.60) with the financial difficulty item of the EORTC QLQ-C30 and week correlation with the items on acute and chronic symptom burdens (nausea/vomiting, –0.18; constipation, –0.14; diarrhea, –0.14), showing good convergent and divergent validity. The median COST-K was 27 (range, 0 to 44; mean±standard deivation [SD], 27.1±7.5) and about 30% and 5% of cancer survivors experienced mild and severe financial toxicity, respectively. Younger age, lower education, lower household income was associated with higher financial toxicity.
Conclusion
The COST-K is a valid and reliable instrument for measuring financial toxicity in disease-free breast cancer survivors. Considering its impact on the health-related quality of life, more studies need to be conducted to evaluate financial toxicity in cancer survivors and design interventions.

Citations

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Financial Hardship Among Newly Diagnosed Patients with Lung Cancer and Their Caregivers: A Dyadic Analysis
Shumin Jia, Yongchun Cui, Denise Shuk Ting Cheung, Pui Hing Chau, Chia-Chin Lin
Seminars in Oncology Nursing.2026; 42(1): 152119. CrossRef
Perceived financial toxicity after active treatment and its association with clinical outcomes among breast cancer survivors: A prospective cohort study
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Yi Kuang, Xiaoyi Yuan, Zheng Zhu, Weijie Xing
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Stevanus Pangestu, Fredrick Dermawan Purba, Hari Setyowibowo, Clara Mukuria, Fanni Rencz
Quality of Life Research.2025; 34(6): 1709. CrossRef
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Yi Kuang, Jiajia Qiu, Ye Liu, Sijin Guo, Ting Chen, Lichen Tang, Winnie K.W. So, Weijie Xing
The Breast.2025; 81: 104441. CrossRef
Cross‐Cultural Validation of the COmprehensive Score for Financial Toxicity (COST) Measure in an Australian Sample
Bora Kim, Claudia Rutherford, Lucy Lehane, Judith Fethney, Louise Acret, Tracy King, Patsy Kenny, Richard De Abreu Lourenco, Kate White
Cancer Medicine.2025;[Epub] CrossRef
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Dal-Lae Jin, Young Ae Kim, Su Jung Lee, Hyun-Ju Seo, Seok-Jun Yoon
Journal of Cancer Survivorship.2025;[Epub] CrossRef
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Yi Kuang, Xiang Qi, Jiajia Qiu, Ye Liu, Sijin Guo, Ting Chen, Lichen Tang, Winnie K. W. So, Weijie Xing
Supportive Care in Cancer.2025;[Epub] CrossRef
Associations of Financial Toxicity with Employment Concerns and Cancer-Related Distress: A Cross-Sectional Survey among Korean Working-Age Cancer Survivors
Hyun-Ju Seo, Dal-Lae Jin, Young Ae Kim, Su Jung Lee, Seok-Jun Yoon
Cancer Research and Treatment.2025; 57(3): 659. CrossRef
Breast Cancer Information Grand Round for Survivorship (BIG-S) prospective cohort
Danbee Kang, Juwon Park, Hyunsoo Kim, Jeong Eon Lee, Seok Jin Nam, Seok Won Kim, Jonghan Yu, Byung Joo Chae, Jai Min Ryu, Juhee Cho, Se Kyung Lee
European Journal of Epidemiology.2025; 40(8): 959. CrossRef
Financial toxicity on treatment outcomes in head & neck cancer patients undergoing radiation therapy
Garrett K. Harada, Eric Ku, Jino Park, Akul Munjal, Nicholas Peterson, Sophie Hsu, Rupali Banker, Shirin Attarian, Erin Healy, Michael Hoyt, Gelareh Sadigh, Allen Chen, Jeremy P. Harris
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L. B. Thomy, M. Crichton, L. Jones, P. M. Yates, N. H. Hart, L. G. Collins, R. J. Chan
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Binh Thang Tran, Dinh Duong Le, Thanh Gia Nguyen, Minh Tu Nguyen, Minh Hanh Nguyen, Cao Khoa Dang, Dinh Trung Tran, Le An Pham
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Stevanus Pangestu, Fanni Rencz
Value in Health.2023; 26(2): 300. CrossRef
Association between financial toxicity and health-related quality of life of patients with gynecologic cancer
Yusuke Kajimoto, Kazunori Honda, Shiro Suzuki, Masahiko Mori, Hirofumi Tsubouchi, Kohshiro Nakao, Anri Azuma, Takashi Shibutani, Shoji Nagao, Takahiro Koyanagi, Izumi Kohara, Shuko Tamaki, Midori Yabuki, Lida Teng, Keiichi Fujiwara, Ataru Igarashi
International Journal of Clinical Oncology.2023; 28(3): 454. CrossRef
Financial Toxicity Following Cancer in a Middle-Income Country with a Pluralistic Health System: Validation of the COST Questionnaire
Veni V. Sakti, Mahmoud Danaee, Cheng-Har Yip, Ros S. A. Bustamam, Marniza Saad, Gin Gin Gan, Jerome Tan, Yueh Ni Lim, Flora L.T. Chong, Murallitharan Munisamy, Farahida Mohd Farid, Boon Lui Sew, Yek-Ching Kong, Nishalini Muniandy, Nirmala Bhoo-Pathy
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Supportive Care in Cancer.2023;[Epub] CrossRef
Validity of the COmprehensive Score for financial Toxicity (COST) in patients with gynecologic cancer
Yusuke Kajimoto, Takashi Shibutani, Shoji Nagao, Satoshi Yamaguchi, Shiro Suzuki, Masahiko Mori, Hirofumi Tsubouchi, Kohshiro Nakao, Anri Azuma, Takahiro Koyanagi, Izumi Kohara, Shuko Tamaki, Midori Yabuki, Lida Teng, Kazunori Honda, Ataru Igarashi
International Journal of Gynecologic Cancer.2022; : ijgc-2022-003410. CrossRef

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Education Level Is a Strong Prognosticator in the Subgroup Aged More Than 50 Years Regardless of the Molecular Subtype of Breast Cancer: A Study Based on the Nationwide Korean Breast Cancer Registry Database: Ki-Tae Hwang, Woochul Noh, Se-Heon Cho, Jonghan Yu, Min Ho Park, Joon Jeong, Hyouk Jin Lee, Jongjin Kim, Sohee Oh, Young A Kim, Korean Breast Cancer Society; Cancer Res Treat. 2017;49(4):1114-1126. Published online February 2, 2017; DOI: https://doi.org/10.4143/crt.2016.528

Abstract PDF Supplementary Material PubReader ePub

Purpose
This study investigated the role of the education level (EL) as a prognostic factor for breast cancer and analyzed the relationship between the EL and various confounding factors.
Materials and Methods
The data for 64,129 primary breast cancer patients from the Korean Breast Cancer Registry were analyzed. The EL was classified into two groups according to the education period; the high EL group (≥ 12 years) and low EL group (< 12 years). Survival analyses were performed with respect to the overall survival between the two groups.
Results
A high EL conferred a superior prognosis compared to a low EL in the subgroup aged > 50 years (hazard ratio, 0.626; 95% confidence interval [CI], 0.577 to 0.678) but not in the subgroup aged ≤ 50 years (hazard ratio, 0.941; 95% CI, 0.865 to 1.024). The EL was a significant independent factor in the subgroup aged > 50 years according to multivariate analyses. The high EL group showed more favorable clinicopathologic features and a higher proportion of patients in this group received lumpectomy, radiation therapy, and endocrine therapy. In the high EL group, a higher proportion of patients received chemotherapy in the subgroups with unfavorable clinicopathologic features. The EL was a significant prognosticator across all molecular subtypes of breast cancer.
Conclusion
The EL is a strong independent prognostic factor for breast cancer in the subgroup aged > 50 years regardless of the molecular subtype, but not in the subgroup aged ≤ 50 years. Favorable clinicopathologic features and active treatments can explain the main causality of the superior prognosis in the high EL group.

Citations

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