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Advances in Clinical Approaches to Breast Cancer Diagnosis and Treatment
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Advances in Clinical Approaches to Breast Cancer Diagnosis and Treatment

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Oncology".

Deadline for manuscript submissions: 31 December 2025 | Viewed by 569

Special Issue Editor

Dr. Lorenzo Scardina

E-Mail Website
Guest Editor
Multidisciplinary Breast Center, Dipartimento Scienze della Salute della Donna e del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy
Interests: breast cancer; oncoplastic breast surgery; conservative mastectomy; conservative breast surgery; prepectoral breast reconstruction; surgical oncology
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Breast cancer remains one of the most prevalent and complex malignancies worldwide, demanding continuous advancements in both diagnostic and therapeutic strategies to improve patient outcomes. Recent breakthroughs in precision medicine, minimally invasive surgical techniques, targeted therapies, and innovative imaging modalities are reshaping the clinical management of breast cancer, allowing for more accurate detection, personalized treatment plans, and enhanced survivorship.

This Special Issue will showcase the latest research and clinical innovations in breast cancer diagnosis and treatment, covering topics such as molecular and genetic profiling, artificial intelligence in imaging, novel systemic and immunotherapies, advancements in breast-conserving surgery, and strategies to mitigate treatment-related side effects. By bringing together leading experts and cutting-edge studies, this collection will provide a comprehensive overview of the evolving landscape of breast cancer care, ultimately guiding future research and improving the quality of life for patients worldwide.

Dr. Lorenzo Scardina
Guest Editor

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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 short 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. Journal of Clinical Medicine 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 2600 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
  • diagnosis
  • precision medicine
  • molecular profiling
  • targeted therapy
  • breast-conserving surgery
  • minimally invasive techniques
  • artificial intelligence
  • personalized medicine
  • radiation therapy

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Published Papers (2 papers)

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Research

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12 pages, 667 KB  
Article
Re-Excision After Positive Margins in Breast-Conserving Surgery: Can a Risk-Based Strategy Avoid Unnecessary Surgery?
by Sabatino D’Archi, Beatrice Carnassale, Cristina Accetta, Flavia De Lauretis, Enrico Di Guglielmo, Alba Di Leone, Antonio Franco, Federica Gagliardi, Stefano Magno, Francesca Moschella, Maria Natale, Eleonora Petrazzuolo, Alejandro Martin Sanchez, Lorenzo Scardina, Marta Silenzi and Gianluca Franceschini
J. Clin. Med. 2025, 14(16), 5839; https://doi.org/10.3390/jcm14165839 - 18 Aug 2025
Viewed by 436
Abstract
Background: Re-excision after breast-conserving surgery (BCS) is routinely recommended when positive margins are found. However, secondary surgery often reveals no residual disease, exposing patients to unnecessary interventions that compromise cosmetic outcomes, increase costs, and reduce quality of life. This study investigates clinicopathological predictors [...] Read more.
Background: Re-excision after breast-conserving surgery (BCS) is routinely recommended when positive margins are found. However, secondary surgery often reveals no residual disease, exposing patients to unnecessary interventions that compromise cosmetic outcomes, increase costs, and reduce quality of life. This study investigates clinicopathological predictors of a residual tumour to identify low-risk patients who may safely avoid re-excision. Methods: We conducted a retrospective cohort study of 135 patients who underwent reoperation for positive margins following BCS at the Breast Unit of Fondazione Policlinico Universitario A. Gemelli IRCCS in Rome, between 2019 and 2024. Data on patient demographics, tumour characteristics, and histopathological findings were analyzed using univariate and multivariate models to identify predictors of residual disease. Results: A residual tumour was detected in 66 of 135 patients (48.9%). In the remaining 69 cases (51.1%), no residual disease was found, indicating that re-excision may have been unnecessary. Multifocality (p < 0.01), lymphovascular invasion (LVI) (p < 0.05), and involvement of ≥2 margins (p < 0.05) were independently associated with the residual tumour. Patients with unifocal disease, absence of LVI, and a single positive margin had a significantly lower risk of residual disease. Conclusions: Over half of re-excisions performed for positive margins may be avoidable. A risk-adapted approach incorporating tumour focality, LVI status, and margin involvement can help identify patients for whom secondary surgery may offer limited benefits. These findings support a more individualized strategy to margin management in BCS aimed at reducing overtreatment without compromising oncologic safety. Full article
(This article belongs to the Special Issue Advances in Clinical Approaches to Breast Cancer Diagnosis and Treatment)
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15 pages, 2457 KB  
Systematic Review
Electrocautery vs. Cold Cutting in Modified Radical Mastectomy: A Systematic Review and Meta-Analysis
by Dennis Cicio, Alin Gheorghe Balta, Teodora Livia Homorozan, Vladimir Ciornei, Octav Marius Russu, Horea Rares Benea and Mihai Pavel
J. Clin. Med. 2025, 14(18), 6437; https://doi.org/10.3390/jcm14186437 (registering DOI) - 12 Sep 2025
Abstract
Background and Objectives: Modified radical mastectomy (MRM) is a common surgical procedure, with outcomes that are influenced by the instruments used in the operation. This meta-analysis aimed to compare “cold cutting” or “traditional” techniques and monopolar or bipolar electrocautery. Materials and Methods: A [...] Read more.
Background and Objectives: Modified radical mastectomy (MRM) is a common surgical procedure, with outcomes that are influenced by the instruments used in the operation. This meta-analysis aimed to compare “cold cutting” or “traditional” techniques and monopolar or bipolar electrocautery. Materials and Methods: A comprehensive search of five databases was conducted, with only studies of adult patients undergoing MRM in clearly defined groups selected. Data from 12 RCTs and 3 cohort studies summarizing 1372 participants was extracted and then synthesized using random-effects models. Risk of Bias was assessed for each of the included studies using the RoB-2 or ROBINS-I tool. Results: Scalpel or scissor use in dissection and flap raising was associated with a significantly lower risk of seroma formation (LogOR = −0.90, 95% CI: −1.26 to −0.54, p < 0.01). Conversely, electrocautery demonstrated advantages including reduced operative time (MD = −13.14 min, 95% CI: −19.58 to −6.70, p < 0.01) and decreased intraoperative blood loss (MD = −171.60 mL, 95% CI: −259.35 to −84.41, p < 0.01). No statistically significant differences were observed in total drain output (MD = −16.45 mL, 95% CI: −170.96 to 138.06, p = 0.83) or duration of drainage (MD = 0.41 days, 95% CI: −0.41 to 1.23, p = 0.32). Similarly, rates of infection, ecchymosis, and flap necrosis did not differ significantly between techniques. Conclusions: Electrocautery should be employed in patients who benefit from a shorter operative time and lower blood loss, while patients in better clinical condition should benefit from cold cutting techniques. Data on patient-reported outcomes and wound cytokine levels were sparse and inconsistent. This meta-analysis was registered in PROSPERO (ID: CRD420251059886). Full article
(This article belongs to the Special Issue Advances in Clinical Approaches to Breast Cancer Diagnosis and Treatment)
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