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Cancers
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New Perspectives in the Management of Breast Cancer
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New Perspectives in the Management of Breast Cancer

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

Deadline for manuscript submissions: 31 December 2025 | Viewed by 8871

Special Issue Editors

Prof. Dr. Sonia Santander Ballestín

E-Mail Website
Guest Editor
Facultad de Medicina, Universidad de Zaragoza, C. de Pedro Cerbuna, 12, 50009 Zaragoza, Spain
Interests: clinical nutrition; pharmacology; endocrine disorders; diet
Special Issues, Collections and Topics in MDPI journals
Prof. Dr. María José Luesma

E-Mail Website
Guest Editor
Facultad de Medicina, Universidad de Zaragoza, C. de Pedro Cerbuna, 12, 50009 Zaragoza, Spain
Interests: obesity; quality of life; body image
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Breast cancer is the most common tumor among women in developed countries. Although it is one of the tumors with the longest survival, mainly due to advances in early detection and treatments, it is important to take into account new perspectives in its management. The approach to breast cancer in terms of future perspectives must take into account multidisciplinary aspects. Thus, early diagnosis tools, the use of new treatments, as well as a nutritional approach based on physical and mental well-being, could allow greater success in the treatment of patients.

Continuous research and the dissemination of new findings are essential to improving the diagnosis, treatment, and prevention of this disease. Through this initiative in the journal Cancers, we aim to support and promote research that can make a significant difference in the fight against breast cancer.

Our goal is to bring together a collection of articles that address breast cancer from multiple perspectives, including, but not limited to, the following:

  • Advances in early detection and innovative diagnostics.
  • New therapies and approaches in treatment.
  • Epidemiological studies and risk factors.
  • Psychosocial impact on patients and their families.
  • Innovations in patient care and attention.
  • The importance of nutrition.
  • The importance of physical exercise.

Instructions for Authors: Articles must be original and have not been previously published. We invite researchers, clinicians, and health professionals to share their studies, systematic reviews, and theoretical analyses that can significantly contribute to the knowledge and management of breast cancer.

We request that manuscripts be prepared following our Cancers journal guidelines. Additionally, we remind you that all articles will undergo a rigorous peer review process to ensure the quality and relevance of the published content.

We are confident that your valuable contribution will be an indispensable resource for our readers and will significantly contribute to the advancement of knowledge in this crucial area of ​​medicine. We look forward to receiving your manuscripts and thank you in advance for your participation in this important initiative.

Prof. Dr. Sonia Santander Ballestín
Prof. Dr. María José Luesma
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
  • treatment
  • nutrition
  • physical exercise
  • psychosocial impact

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Further information on MDPI's Special Issue policies can be found here.

Published Papers (6 papers)

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Research

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14 pages, 1030 KiB  
Article
The Role of Engagement in Virtual Reality to Enhance Emotional Well-Being in Breast Cancer Patients: A Mediation Analysis
by Hélène Buche, Aude Michel, Royce Anders and Nathalie Blanc
Cancers 2025, 17(5), 840; https://doi.org/10.3390/cancers17050840 - 28 Feb 2025
Cited by 1 | Viewed by 874
Abstract
Introduction: Virtual reality (VR) has garnered increasing attention in oncology due to its potential to enhance patient care by alleviating anxiety and emotional distress. The present work evaluates the hypothesis proposed by a recent theoretical model that engagement and the sense of presence [...] Read more.
Introduction: Virtual reality (VR) has garnered increasing attention in oncology due to its potential to enhance patient care by alleviating anxiety and emotional distress. The present work evaluates the hypothesis proposed by a recent theoretical model that engagement and the sense of presence are key mediators that impact the degree of beneficial effects that VR may have on the emotional well-being of breast cancer patients. Methods: This study draws on data from three previous studies comprising 156 breast cancer patients. The psychological variables of well-being studied included emotional dimensions measured before and after exposure to a virtual environment, as well as factors related to immersive qualities. Correlation and mediation analyses were conducted to explore relationships among said variables, namely, one’s tendency to be immersed in an activity, engagement, spatial presence, and emotional well-being (i.e., valence and arousal) of the patients. Results: Engagement plays a crucial mediating role between tendency of immersion, spatial presence, and positive emotional responses. Patients with a greater tendency toward immersion and higher engagement in the virtual environment showed significant emotional improvements. However, tendency of immersion and spatial presence alone did not directly lead to more positive emotional experiences; their influence was primarily exerted through engagement. Conclusions: Engagement emerges as a fundamental lever for maximizing the psychological benefits of VR in oncology. Clinical interventions using VR should prioritize optimizing engagement in immersive environments to improve patients’ emotional state throughout their cancer treatment journey. Full article
(This article belongs to the Special Issue New Perspectives in the Management of Breast Cancer)
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16 pages, 826 KiB  
Article
Comparison of Survival Outcomes of Breast-Conserving Surgery Plus Radiotherapy with Mastectomy in Early Breast Cancer Patients: Less Is More?
by Chularat Duangkaew, Areewan Somwangprasert, Kirati Watcharachan, Phanchaporn Wongmaneerung, Wasana Ko-iam, Issara Kaweewan and Chagkrit Ditsatham
Cancers 2025, 17(4), 591; https://doi.org/10.3390/cancers17040591 - 9 Feb 2025
Viewed by 1550
Abstract
Purpose: To compare the survival outcomes of early-stage breast cancer patients treated with breast-conserving therapy (BCT) and mastectomy. Method: This retrospective study includes 1330 early-stage breast cancer patients treated at Chiang Mai University (CMU) hospital, using data from the Chiang Mai Cancer Registry [...] Read more.
Purpose: To compare the survival outcomes of early-stage breast cancer patients treated with breast-conserving therapy (BCT) and mastectomy. Method: This retrospective study includes 1330 early-stage breast cancer patients treated at Chiang Mai University (CMU) hospital, using data from the Chiang Mai Cancer Registry between 2004 and 2015. Information pertinent to patients and their treatment was collected for analysis. Time-to-event analysis was performed using Kaplan–Meier methods. Results: The baseline characteristics of 1330 patients showed significant differences between the BCT and mastectomy groups in terms of age, tumor size, and tumor location. BCT patients were younger, had smaller tumors, and exhibited less nodal involvement. Propensity score matching created a balanced cohort of 534 patients where differences persisted in age and tumor size. Univariate analysis revealed significant survival associations for BCT, younger age, and smaller tumor size. Multivariate analysis confirmed these factors, with BCT showing an adjusted hazard ratio (HR) of 0.58 (95% CI: 0.36–0.93; p = 0.023) compared to mastectomy. Kaplan–Meier survival analysis demonstrated a significant survival advantage for BCT, particularly in HER2-enriched and triple-negative subtypes. The 15-year overall survival was 80.01% in the BCT group versus 64.33% in the mastectomy group (p < 0.001). Conclusions: This study reveals key differences between outcomes following breast-conserving therapy (BCT) and mastectomy patients, including age and tumor characteristics. BCT showed improved overall survival, particularly in HER2-enriched and triple-negative breast cancers. However, our study’s limitations may affect the results. These findings suggest that BCT may offer survival benefits for specific subtypes, highlighting the importance of personalized treatment approaches. Full article
(This article belongs to the Special Issue New Perspectives in the Management of Breast Cancer)
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16 pages, 1983 KiB  
Article
Hypnosis Sedation Used in Breast Oncologic Surgery Significantly Decreases Perioperative Inflammatory Reaction
by Martine Berliere, Fabienne Roelants, François P. Duhoux, Amandine Gerday, Nathan Piette, Camille Lacroix, Marie-Agnes Docquier, Vasiliki Samartzi, Maude Coyette, Jennifer Hammer, Nassim Touil, Houda Azzouzi, Philippe Piette and Christine Watremez
Cancers 2025, 17(1), 49; https://doi.org/10.3390/cancers17010049 - 27 Dec 2024
Cited by 1 | Viewed by 983
Abstract
Background: Hypnosis sedation has recently been used for anesthesia in breast oncologic surgery. Methods: Between January 2017 and October 2019, 284 patients from our Breast Clinic (Cliniques Universitaires Saint-Luc, Université Catholique de Louvain) and from the Jolimont Hospital were prospectively included in an [...] Read more.
Background: Hypnosis sedation has recently been used for anesthesia in breast oncologic surgery. Methods: Between January 2017 and October 2019, 284 patients from our Breast Clinic (Cliniques Universitaires Saint-Luc, Université Catholique de Louvain) and from the Jolimont Hospital were prospectively included in an interventional non-randomized study approved by our two local ethics committees and registered on clinicaltrials.gov (NCT03330117). Ninety-three consecutive patients underwent surgery while on general anesthesia (GA group). Ninety-two consecutive patients underwent surgery while on general anesthesia preceded by a hypnorelaxation session (GAVRH group). Ninety-five consecutive patients underwent surgery while exclusively on hypnosis sedation (HYPS group). Clinical parameters (pain score, anxiety and distress score) were measured on days 0, 1 and 8 for all patients. All evaluable patients underwent NLR (neutrophil-to-lymphocyte ratio) and CRP (C-reactive protein) dosage on days 0, 1 and 8. Results: Pain scores and anxiety scores were statistically lower in the HYPS group on days 1 and 8, as was the duration of NSAID consumption. NLR and CRP values were significantly inferior on day 1 for all patients who benefited from hypnosis sedation. Conclusions: Some benefits of hypnosis sedation (reduction in postoperative pain, decrease in NSAID consumption) are correlated with a significant reduction in inflammatory parameters in the perioperative process. Full article
(This article belongs to the Special Issue New Perspectives in the Management of Breast Cancer)
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12 pages, 843 KiB  
Article
Evaluating CDK4/6 Inhibitor Therapy in Elderly Patients with Metastatic Hormone Receptor-Positive, HER2-Negative Breast Cancer: A Retrospective Real-World Multicenter Study
by Palma Fedele, Matteo Landriscina, Lucia Moraca, Antonio Cusmai, Antonio Gnoni, Antonella Licchetta, Chiara Guarini, Laura Lanotte, Maria Nicla Pappagallo, Assunta Melaccio, Guido Giordano, Felicia Maria Maselli, Antonello Pinto, Francesco Giuliani, Vincenzo Chiuri, Francesco Giotta and Gennaro Gadaleta-Caldarola
Cancers 2024, 16(20), 3442; https://doi.org/10.3390/cancers16203442 - 10 Oct 2024
Cited by 2 | Viewed by 1301
Abstract
Background: Metastatic HR+/HER2- breast cancer is commonly treated with CDK4/6 inhibitors in combination with endocrine therapy. However, the efficacy and safety of this approach in elderly patients (≥70 years) remain unclear, particularly in the context of real-world clinical practice. This study aims to [...] Read more.
Background: Metastatic HR+/HER2- breast cancer is commonly treated with CDK4/6 inhibitors in combination with endocrine therapy. However, the efficacy and safety of this approach in elderly patients (≥70 years) remain unclear, particularly in the context of real-world clinical practice. This study aims to evaluate the clinical outcomes and tolerability of CDK4/6 inhibitor treatments in this fragile population, which is often under-represented in randomized clinical trials. Patients and methods: This retrospective multicenter study included elderly patients with metastatic HR+/HER2-negative breast cancer receiving first-line CDK4/6 inhibitors. The primary endpoint was progression-free survival (PFS). The secondary endpoints focused on the overall survival (OS), safety, and tolerability, considering variables such as tumor subtype, age, comorbidities, and treatment specifics. Results: The median PFS and OS were slightly lower than those reported in clinical trials, reflecting the inclusion of a more fragile population. The luminal B subtype was linked to a poorer PFS, while other factors like age, BMI, and ECOG status did not significantly affect the outcomes. A safety analysis indicated a higher incidence of grade 3 or higher toxicities, especially in frail patients, leading to dose reductions. Despite these challenges, CDK4/6 inhibitors were generally well-tolerated, allowing most patients to continue therapy. Conclusions: CDK4/6 inhibitors with endocrine therapy are effective in elderly patients with metastatic HR+/HER2- breast cancer, though careful management is crucial to balance efficacy and minimize adverse events. Full article
(This article belongs to the Special Issue New Perspectives in the Management of Breast Cancer)
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Review

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20 pages, 812 KiB  
Review
Advances in CDK4 and 6 Inhibitors: Transforming Breast Cancer Treatment
by Sonia Santander Ballestín, María Abadía Labena, Ana Avedillo-Salas, Cristina Marco Continente, Marina Arribas Blázquez and María José Luesma Bartolomé
Cancers 2025, 17(5), 760; https://doi.org/10.3390/cancers17050760 - 24 Feb 2025
Viewed by 711
Abstract
Background and Objectives: Breast cancer is the most common malignant neoplasm worldwide and the most prevalent one among women. It represents the leading cause of cancer-related death among females. Cyclin-dependent kinase 4 and 6 inhibitors disrupt the cell cycle, inducing cellular senescence and, [...] Read more.
Background and Objectives: Breast cancer is the most common malignant neoplasm worldwide and the most prevalent one among women. It represents the leading cause of cancer-related death among females. Cyclin-dependent kinase 4 and 6 inhibitors disrupt the cell cycle, inducing cellular senescence and, ultimately, apoptosis. Consequently, they have become a novel type of adjuvant therapy for the treatment of advanced or metastatic breast cancer characterised by positive hormone receptors and human epidermal growth factor receptor 2 (HER-2) negative. Methods: A systematic review was conducted, analysing the available literature on cyclin-dependent kinase 4 and 6 inhibitors published over the last five years. The aim was to evaluate the efficacy and safety of adding these drugs to the standard endocrine therapy for this pathology. Results: The combination of cyclin-dependent kinase 4 and 6 inhibitors with endocrine therapy was shown to improve progression-free survival, overall survival, and chemotherapy-free intervals in patients who received this combination therapy. Conclusions: The addition of CDK4/6 inhibitors to endocrine therapy in the treatment of advanced or metastatic breast cancer with positive hormone receptors and HER-2 negative significantly improved PFS, median survival, and chemotherapy-free intervals compared with the use of hormonal treatments alone or in combination with a placebo. Currently, CDK4/6 inhibitors are becoming established as a new standard treatment for this pathology, offering lower toxicity than chemotherapy. However, it is necessary to deeply investigate the mechanisms of treatment resistance and develop effective therapies to overcome them. Full article
(This article belongs to the Special Issue New Perspectives in the Management of Breast Cancer)
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39 pages, 1154 KiB  
Review
Targeted Therapy in Breast Cancer: Advantages and Advancements of Antibody–Drug Conjugates, a Type of Chemo-Biologic Hybrid Drugs
by Attrayo Mukherjee and Debasish Bandyopadhyay
Cancers 2024, 16(20), 3517; https://doi.org/10.3390/cancers16203517 - 17 Oct 2024
Viewed by 2941
Abstract
Cancer is a significant health challenge globally, with millions of people affected every year, resulting in high morbidity and mortality. Although other treatment options are available with limitations, chemotherapy, either standalone or combined with other therapeutic procedures, is the most commonly used practice [...] Read more.
Cancer is a significant health challenge globally, with millions of people affected every year, resulting in high morbidity and mortality. Although other treatment options are available with limitations, chemotherapy, either standalone or combined with other therapeutic procedures, is the most commonly used practice of treating cancer. In chemotherapy, cancer cells/malignant tumors are targeted; however, due to less target specificity, along with malignant cells, normal cells are also affected, which leads to various off-target effects (side effects) that impact the patient quality of life. Out of all the different types of cancers, breast cancer is the most common type of cancer in humans worldwide. Current anticancer drug discovery research aims to develop therapeutics with higher potency and lower toxicity, which is only possible through target-specific therapy. Antibody–drug conjugates (ADCs) are explicitly designed to target malignant tumors and minimize off-target effects by reducing systemic cytotoxicity. Several ADCs have been approved for clinical use and have shown moderate to good efficacy so far. Considering various aspects, chemotherapy and ADCs are useful in treating cancer. However, ADCs provide a more focused and less toxic approach, which is especially helpful in cases where resistance to chemotherapy (drug resistance) occurs and in the type of malignancies in which specific antigens are overexpressed. Ongoing ADC research aims to develop more target-specific cancer treatments. In short, this study presents a concise overview of ADCs specific to breast cancer treatment. This study provides insight into the classifications, mechanisms of action, structural aspects, and clinical trial phases (current status) of these chemo-biologic drugs (ADCs). Full article
(This article belongs to the Special Issue New Perspectives in the Management of Breast Cancer)
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