Breast Carcinoma

MONDO:0004989 Pathograph 4 Show in embeddings browser thoracic cancer

Breast carcinoma is a malignant epithelial tumor of the breast whose clinical behavior and treatment are stratified by estrogen/progesterone receptor and HER2 status. The receptor-defined subsets are curated in depth in the separate ER_Positive_Breast_Cancer, HER2_Positive_Breast_Cancer, Triple_Negative_Breast_Cancer, and PIK3CA_Mutant_Breast_Cancer entries; this entry carries the shared breast-carcinoma biology and the metastatic stage. Advanced disease disseminates with particular tropism for bone, lung, brain, and liver; metastatic competence emerges through epithelial to mesenchymal transition, collective and single-cell invasion, angiogenesis, immune evasion, and adaptation to organ-specific microenvironments. During dissemination, endocrine and HER2 pathway dependence may be retained, lost, or reconfigured through clonal selection and receptor discordance, creating clinically important differences between primary and metastatic lesions.

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1
Mappings
5
Pathophys.
5
Phenotypes
1
Gaps
4
Pathograph
4
Genes
6
Medical Actions
4
Subtypes
3
Trials
15
References
🔗

Mappings

MONDO
MONDO:0004989 breast carcinoma
skos:exactMatch MONDO
MONDO provides an exact disease term for breast carcinoma. This entry was reconstituted from the former Metastatic_Breast_Carcinoma entry (cancer granularity ladder, design decisions §3a): stage is not a taxon, so the metastatic view now lives in this entry's Metastatic stage.
◆

Subtypes

4
ER-Positive Breast Cancer
Pointer subtype (design decisions section 3a(d)): curated in depth as the separate ER_Positive_Breast_Cancer entry.
HER2-Positive Breast Cancer
Pointer subtype: curated in depth as the separate HER2_Positive_Breast_Cancer entry.
Triple-Negative Breast Cancer
Pointer subtype: curated in depth as the separate Triple_Negative_Breast_Cancer entry, which carries its own MONDO term (MONDO:0005494).
PIK3CA-Mutant Breast Cancer
Pointer subtype: curated in depth as the separate PIK3CA_Mutant_Breast_Cancer entry.
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Discussions and Knowledge Gaps

1
What are the primary-tumour mechanisms of breast carcinoma - ductal epithelial transformation, DCIS-to-invasive progression, and the receptor-pathway biology that defines the major subtypes - and how do they connect to the metastatic mechanisms this entry already models?
KNOWLEDGE GAP OPEN gap_breast_carcinoma_primary_tumour_mechanism
Attached to
pathophysiology# stages#Early-stage
This entry was reconstituted from the former Metastatic_Breast_Carcinoma entry under the cancer granularity ladder (design decisions section 3a). The pathophysiology it inherited is metastasis biology plus receptor heterogeneity, so the Early-stage stage carries no mechanism content: ductal epithelial transformation, DCIS-to-invasive progression, and the ER/HER2 pathway biology that drives the receptor-defined subtypes are not modeled here. Those subtypes are curated in their own entries (see has_subtypes pointers), but the shared primary-tumour chain that would sit above them is a genuine gap in this base entry rather than content deliberately delegated.
⚙

Pathophysiology

5
EMT-Driven Dissemination
Metastatic breast carcinoma acquires motile and invasive phenotypes through epithelial to mesenchymal transition and related plasticity programs. EMT reduces epithelial adhesion, increases migratory behavior, and facilitates escape from the primary tumor, intravasation, and colonization of distant tissue niches.
epithelial to mesenchymal transition GO:0001837 Gene Ontology (GO) Relation: this pathophysiological event involves this biological process This pathophysiological event involves increased epithelial to mesenchymal transition (GO:0001837). GO:0001837 is a biological process from the Gene Ontology. ↑ INCREASED cell migration GO:0016477 Gene Ontology (GO) Relation: this pathophysiological event involves this biological process This pathophysiological event involves increased cell migration (GO:0016477). GO:0016477 is a biological process from the Gene Ontology. ↑ INCREASED positive regulation of cell migration GO:0030335 Gene Ontology (GO) Relation: this pathophysiological event involves this biological process This pathophysiological event involves increased positive regulation of cell migration (GO:0030335). GO:0030335 is a biological process from the Gene Ontology. ↑ INCREASED
Downstream
Organ-Specific Tropism Cells that have escaped the primary tumour through EMT-like plasticity colonise distant sites in the seed-and-soil pattern characteristic of breast carcinoma.
Show evidence (1 reference)
PMID:37386445 SUPPORT Human Clinical
"The metastasis of cancer cells from the primary tumor site to other organs in the body, notably the lungs, bones, brain, and liver, is what causes breast cancer to ultimately be fatal."
This supports the central role of distant dissemination and organotropism in lethal breast cancer.
Organ-Specific Tropism
Breast cancer metastases display seed-and-soil behavior, with preferential colonization of bone, lung, brain, and liver. This reflects both intrinsic tumor programs and permissive microenvironments, including osteotropic signaling in bone, vascular adaptation in lung, and blood-brain barrier traversal in brain metastasis.
cell migration GO:0016477 Gene Ontology (GO) Relation: this pathophysiological event involves this biological process This pathophysiological event involves increased cell migration (GO:0016477). GO:0016477 is a biological process from the Gene Ontology. ↑ INCREASED
Downstream
Immune Evasion in Metastatic Niches Disseminated cells adapt to organ-specific immune milieus, recruiting suppressive populations that let metastatic clones persist.
Angiogenic Outgrowth Micrometastatic foci in bone, lung, brain and liver require neovascular support to survive and expand.
Show evidence (1 reference)
PMID:37386445 SUPPORT Human Clinical
"The metastasis of cancer cells from the primary tumor site to other organs in the body, notably the lungs, bones, brain, and liver, is what causes breast cancer to ultimately be fatal."
This directly supports the dominant distant sites highlighted in metastatic breast cancer.
ER and HER2 Receptor Heterogeneity
Intratumoral spatial heterogeneity in estrogen receptor (ER), progesterone receptor (PR), and HER2 expression occurs in a meaningful subset of breast tumors, with biomarker status differing between sampled regions of the same tumor. This heterogeneity affects breast cancer classification accuracy from biopsy sampling and has clinical implications for selecting endocrine and HER2-targeted therapy.
estrogen receptor signaling pathway GO:0030520 Gene Ontology (GO) Relation: this pathophysiological event involves this biological process This pathophysiological event involves abnormal estrogen receptor signaling pathway (GO:0030520). GO:0030520 is a biological process from the Gene Ontology. ⚠ ABNORMAL cell surface receptor protein tyrosine kinase signaling pathway GO:0007169 Gene Ontology (GO) Relation: this pathophysiological event involves this biological process This pathophysiological event involves abnormal cell surface receptor protein tyrosine kinase signaling pathway (GO:0007169). GO:0007169 is a biological process from the Gene Ontology. ⚠ ABNORMAL
Show evidence (1 reference)
PMID:27349894 SUPPORT Human Clinical
"Intratumoral biomarker heterogeneity may impact breast cancer classification accuracy, with implications for clinical management."
This supports clinically meaningful intratumoral ER/PR/HER2 heterogeneity within primary breast cancers, affecting biomarker-based classification and treatment selection.
Angiogenic Outgrowth
Successful metastatic colonization requires neovascular support both at the primary site and in distant lesions. Angiogenesis promotes survival of micrometastatic foci, sustains growth in bone and lung deposits, and supports blood-brain barrier adaptation in brain metastases.
angiogenesis GO:0001525 Gene Ontology (GO) Relation: this pathophysiological event involves this biological process This pathophysiological event involves increased angiogenesis (GO:0001525). GO:0001525 is a biological process from the Gene Ontology. ↑ INCREASED
Immune Evasion in Metastatic Niches
Disseminated breast cancer cells evade immune elimination by remodeling cytokine gradients, recruiting suppressive myeloid and lymphoid populations, and adapting to organ-specific immune milieus. These programs help metastatic clones persist despite host antitumor surveillance and systemic therapy.
negative regulation of immune response GO:0050777 Gene Ontology (GO) Relation: this pathophysiological event involves this biological process This pathophysiological event involves increased negative regulation of immune response (GO:0050777). GO:0050777 is a biological process from the Gene Ontology. ↑ INCREASED
⬡

Pathograph

Use the checkboxes to hide or show graph categories. Hover nodes for evidence and cross-linked metadata.
Pathograph: causal mechanism network for Breast Carcinoma Interactive directed graph showing how pathophysiology mechanisms, phenotypes, genetic factors and variants, experimental models, environmental triggers, and treatments relate through causal and linked edges.
●

Phenotypes

5
Nervous System 1
Headache FREQUENT HP:0002315 Human Phenotype Ontology (HP) Relation: this clinical feature is this phenotype This clinical feature is Headache (HP:0002315). HP:0002315 is a phenotype from the Human Phenotype Ontology.
Respiratory 1
Dyspnea FREQUENT HP:0002094 Human Phenotype Ontology (HP) Relation: this clinical feature is this phenotype This clinical feature is Dyspnea (HP:0002094). HP:0002094 is a phenotype from the Human Phenotype Ontology.
Constitutional 2
Bone pain VERY_FREQUENT HP:0002653 Human Phenotype Ontology (HP) Relation: this clinical feature is this phenotype This clinical feature is Bone pain (HP:0002653). HP:0002653 is a phenotype from the Human Phenotype Ontology.
Fatigue VERY_FREQUENT HP:0012378 Human Phenotype Ontology (HP) Relation: this clinical feature is this phenotype This clinical feature is Fatigue (HP:0012378). HP:0012378 is a phenotype from the Human Phenotype Ontology.
Growth 1
Weight loss FREQUENT HP:0001824 Human Phenotype Ontology (HP) Relation: this clinical feature is this phenotype This clinical feature is Weight loss (HP:0001824). HP:0001824 is a phenotype from the Human Phenotype Ontology.
🧬

Genetic Associations

4
ESR1 (Acquired endocrine resistance mutation)
Gene: ESR1 hgnc:3467 HUGO Gene Nomenclature Committee (hgnc) Relation: this disease-associated gene is this gene This disease-associated gene is ESR1 (hgnc:3467). hgnc:3467 is a gene from the HUGO Gene Nomenclature Committee.
ERBB2 (HER2) (Amplification or overexpression)
PIK3CA (Somatic activating mutation)
Gene: PIK3CA hgnc:8975 HUGO Gene Nomenclature Committee (hgnc) Relation: this disease-associated gene is this gene This disease-associated gene is PIK3CA (hgnc:8975). hgnc:8975 is a gene from the HUGO Gene Nomenclature Committee.
TP53 (Somatic loss of function)
Gene: TP53 hgnc:11998 HUGO Gene Nomenclature Committee (hgnc) Relation: this disease-associated gene is this gene This disease-associated gene is TP53 (hgnc:11998). hgnc:11998 is a gene from the HUGO Gene Nomenclature Committee.
💊

Medical Actions

6
CDK4/6 Inhibitor Plus Endocrine Therapy
Action: PharmacotherapyNCI Thesaurus (NCIT) Relation: this treatment is this clinical intervention This treatment is Pharmacotherapy (NCIT:C15986). NCIT:C15986 is a clinical intervention from the NCI Thesaurus. NCIT:C15986
Agent: palbociclib CHEBI:85993 Chemical Entities of Biological Interest (CHEBI) Relation: this treatment uses this therapeutic agent This treatment uses palbociclib (CHEBI:85993). CHEBI:85993 is a therapeutic agent from Chemical Entities of Biological Interest. fulvestrant CHEBI:31638 Chemical Entities of Biological Interest (CHEBI) Relation: this treatment uses this therapeutic agent This treatment uses fulvestrant (CHEBI:31638). CHEBI:31638 is a therapeutic agent from Chemical Entities of Biological Interest.
HR-positive, HER2-negative metastatic breast carcinoma is commonly treated with endocrine therapy combined with a CDK4/6 inhibitor, using aromatase inhibitor or fulvestrant backbones selected by treatment history and resistance profile.
Show evidence (2 references)
DOI:10.1007/s10549-024-07376-w SUPPORT Human Clinical
"Patients receiving 1st-line aromatase inhibitor + CDK4/6 inhibitor (n = 573) with ESR1mut had less favorable rwPFS and rwOS versus ESR1 wild-type; no differences were observed for fulvestrant + CDK4/6 inhibitor (n = 348)."
Real-world metastatic HR+/HER2- cohorts document aromatase-inhibitor and fulvestrant backbones paired with CDK4/6 inhibitors in first-line therapy.
PMID:41744884 SUPPORT Other
"for HR+/HER2- mBC, first-line endocrine therapy plus CDK4/6 inhibitor, followed by targeted agents, chemotherapy, or antibody-drug conjugates based on progression and visceral crisis"
The Romanian consensus statement recommends first-line endocrine therapy plus a CDK4/6 inhibitor for HR-positive/HER2-negative metastatic breast cancer.
Elacestrant Oral SERD for ESR1-Mutated Disease
Action: PharmacotherapyNCI Thesaurus (NCIT) Relation: this treatment is this clinical intervention This treatment is Pharmacotherapy (NCIT:C15986). NCIT:C15986 is a clinical intervention from the NCI Thesaurus. NCIT:C15986
Agent: elacestrant CHEBI:229213 Chemical Entities of Biological Interest (CHEBI) Relation: this treatment uses this therapeutic agent This treatment uses elacestrant (CHEBI:229213). CHEBI:229213 is a therapeutic agent from Chemical Entities of Biological Interest.
Elacestrant is an oral selective estrogen receptor degrader used after prior endocrine therapy for ER-positive, HER2-negative metastatic breast carcinoma with ESR1 mutations.
Show evidence (1 reference)
DOI:10.1200/jco.23.02112 SUPPORT Human Clinical
"The US Food and Drug Administration (FDA) approved elacestrant for the treatment of postmenopausal women or adult men with estrogen receptor–positive (ER+), human epidermal growth factor receptor 2–negative (HER2–), estrogen receptor 1 ( ESR1)–mutated advanced or metastatic breast cancer with..."
FDA approval summary supports elacestrant for ESR1-mutated ER+/HER2- advanced or metastatic breast cancer after endocrine therapy.
Capivasertib Plus Fulvestrant for PI3K/AKT/PTEN-Altered Disease
Action: PharmacotherapyNCI Thesaurus (NCIT) Relation: this treatment is this clinical intervention This treatment is Pharmacotherapy (NCIT:C15986). NCIT:C15986 is a clinical intervention from the NCI Thesaurus. NCIT:C15986
Agent: capivasertib CHEBI:229222 Chemical Entities of Biological Interest (CHEBI) Relation: this treatment uses this therapeutic agent This treatment uses capivasertib (CHEBI:229222). CHEBI:229222 is a therapeutic agent from Chemical Entities of Biological Interest. fulvestrant CHEBI:31638 Chemical Entities of Biological Interest (CHEBI) Relation: this treatment uses this therapeutic agent This treatment uses fulvestrant (CHEBI:31638). CHEBI:31638 is a therapeutic agent from Chemical Entities of Biological Interest.
Capivasertib plus fulvestrant targets AKT-pathway dependence in HR-positive, HER2-negative metastatic breast carcinoma with PIK3CA, AKT1, or PTEN alterations after progression on endocrine therapy.
Show evidence (1 reference)
clinicaltrials:NCT04305496 SUPPORT Human Clinical
"Phase III, double-blind, randomised study assessing the efficacy of capivasertib + fulvestrant vs placebo + fulvestrant for the treatment of patients with locally advanced (inoperable) or metastatic HR+/HER2- breast cancer following recurrence or progression on or after AI therapy."
CAPItello-291 directly evaluates capivasertib plus fulvestrant in locally advanced or metastatic HR+/HER2- breast cancer after aromatase-inhibitor progression.
PARP Inhibitors for Germline BRCA-Mutated Disease
Action: targeted therapyNCI Thesaurus (NCIT) Relation: this treatment is this clinical intervention This treatment is targeted therapy (NCIT:C93352). NCIT:C93352 is a clinical intervention from the NCI Thesaurus. Ontology label: Targeted Therapy NCIT:C93352
Agent: olaparib CHEBI:83766 Chemical Entities of Biological Interest (CHEBI) Relation: this treatment uses this therapeutic agent This treatment uses olaparib (CHEBI:83766). CHEBI:83766 is a therapeutic agent from Chemical Entities of Biological Interest. talazoparib CHEBI:231344 Chemical Entities of Biological Interest (CHEBI) Relation: this treatment uses this therapeutic agent This treatment uses talazoparib (CHEBI:231344). CHEBI:231344 is a therapeutic agent from Chemical Entities of Biological Interest.
PARP inhibitors exploit homologous recombination deficiency in metastatic breast carcinoma with germline BRCA1 or BRCA2 pathogenic variants.
Show evidence (1 reference)
DOI:10.1038/s41416-024-02827-z SUPPORT Human Clinical
"BC resulting from a germline BRCAm (gBRCAm) has distinct clinical characteristics along with increased sensitivity to DNA-damaging agents such as poly(ADP-ribose) polymerase (PARP) inhibitors and platinum-based chemotherapies, and potentially decreased sensitivity to cyclin-dependent kinase 4..."
Review-level evidence supports PARP inhibitor sensitivity in germline BRCA-mutated breast cancer, including advanced-disease treatment planning.
Trastuzumab Deruxtecan for HER2-Positive or HER2-Low Disease
Action: immunotherapyNCI Thesaurus (NCIT) Relation: this treatment is this clinical intervention This treatment is immunotherapy (NCIT:C15262). NCIT:C15262 is a clinical intervention from the NCI Thesaurus. Ontology label: Immunotherapy NCIT:C15262
Agent: trastuzumab deruxtecan NCIT:C128799 NCI Thesaurus (NCIT) Relation: this treatment uses this therapeutic agent This treatment uses trastuzumab deruxtecan (NCIT:C128799). NCIT:C128799 is a therapeutic agent from the NCI Thesaurus.
Trastuzumab deruxtecan is an antibody-drug conjugate used for metastatic breast carcinoma with HER2-positive or HER2-low expression after appropriate prior therapy.
Show evidence (1 reference)
DOI:10.3390/cancers17213505 SUPPORT Human Clinical
"Trastuzumab–deruxtecan (T-DXd), a new-generation antibody drug conjugate, has greatly improved the survival and clinical benefit rates of patients affected by advanced HER2-positive/HER2-low breast cancer according to the results of controlled clinical trials with a manageable safety profile."
This review summarizes T-DXd benefit for advanced HER2-positive and HER2-low metastatic breast cancer.
Sacituzumab Govitecan Antibody-Drug Conjugate
Action: PharmacotherapyNCI Thesaurus (NCIT) Relation: this treatment is this clinical intervention This treatment is Pharmacotherapy (NCIT:C15986). NCIT:C15986 is a clinical intervention from the NCI Thesaurus. NCIT:C15986
Agent: sacituzumab govitecan NCIT:C102783 NCI Thesaurus (NCIT) Relation: this treatment uses this therapeutic agent This treatment uses sacituzumab govitecan (NCIT:C102783). NCIT:C102783 is a therapeutic agent from the NCI Thesaurus.
Sacituzumab govitecan is a Trop-2-directed antibody-drug conjugate used for metastatic breast carcinoma after prior systemic therapy, including HR-positive/HER2-negative disease after multiple chemotherapy regimens.
Show evidence (1 reference)
clinicaltrials:NCT04639986 SUPPORT Human Clinical
"The goal of this study is to compare the study drug, sacituzumab govitecan-hziy, versus doctors' treatment of choice in participants with HR+/HER2- metastatic breast cancer (MBC) who have failed at least 2 prior chemotherapy regimens."
The phase 3 record supports sacituzumab govitecan evaluation in heavily pretreated HR+/HER2- metastatic breast cancer.
🌍

Environmental Factors

2
Obesity
Obesity increases inflammatory and endocrine signals that can promote recurrence and metastatic progression.
Show evidence (1 reference)
PMID:35579841 SUPPORT Human Clinical
"the summary relative risk (RR) for obese women was 1.21 (1.15-1.27) for all-cause mortality, 1.22 (1.13-1.32) for BCSM, 1.12 (1.06-1.18) for recurrence, and 1.19 (1.11-1.28) for distant recurrence"
Meta-analysis of prospective cohorts quantifies obesity's association with breast cancer recurrence and distant recurrence.
Alcohol exposure
exposure to alcohol consumption ECTO:0001082 Environmental Conditions, Treatments and Exposures Ontology (ECTO) Relation: this environmental factor is this exposure This environmental factor is exposure to alcohol consumption (ECTO:0001082). ECTO:0001082 is an exposure from the Environmental Conditions, Treatments and Exposures Ontology.
Alcohol contributes to breast cancer risk and may amplify metastatic recurrence risk through endocrine and inflammatory effects.
Show evidence (1 reference)
PMID:32090238 SUPPORT Human Clinical
"when adding 10 g per day, the risk increased by 10.5% (RR = 1.10, 95%CI = 1.08-1.13) in total alcohol and 8.9% (RR = 1.08, 95%CI = 1.04-1.14) in wine"
Dose-response meta-analysis of prospective cohorts quantifies alcohol's contribution to breast cancer risk.
🪜

Stages

2
Early-stage
Disease confined to the breast and regional lymph nodes, treated with curative intent by surgery, radiotherapy, and receptor-guided systemic therapy.
Metastatic
Advanced breast carcinoma disseminated to distant organs, with particular tropism for bone, lung, brain, and liver. Receptor status may differ between primary and metastatic lesions, and systemic therapy is selected by the receptor and genomic profile of the metastatic disease.
This stage carries the content of the former Metastatic_Breast_Carcinoma entry (cancer granularity ladder, design decisions §3a). Brain metastases occur in up to 30% of advanced breast cancer cases, and 5-year survival differs sharply by intrinsic subtype.
Show evidence (2 references)
PMID:37386445 SUPPORT Human Clinical
"Brain metastases occur in as many as 30% of patients with advanced breast cancer, and the 1-year survival rate of these patients is around 20%."
Summarizes the burden of brain dissemination in advanced breast cancer.
PMID:36138404 SUPPORT Human Clinical
"The 5-year survival rate was highest for HER2+/Luminal (46%) patients, followed by Luminal B (29%), Luminal A (28%), HER2+/ER- (21%), and TNBC (7%)."
Provides subtype-stratified long-term survival data for the metastatic stage.
🔬

Clinical Trials

3
CAPItello-291 PHASE_III ACTIVE_NOT_RECRUITING
Phase 3 randomized study of capivasertib plus fulvestrant versus placebo plus fulvestrant in locally advanced or metastatic HR+/HER2- breast cancer after recurrence or progression on aromatase-inhibitor therapy.
Show evidence (1 reference)
clinicaltrials:NCT04305496 SUPPORT Human Clinical
"Phase III, double-blind, randomised study assessing the efficacy of capivasertib + fulvestrant vs placebo + fulvestrant for the treatment of patients with locally advanced (inoperable) or metastatic HR+/HER2- breast cancer following recurrence or progression on or after AI therapy."
ClinicalTrials.gov summary establishes the CAPItello-291 regimen and metastatic HR+/HER2- population.
EMERALD PHASE_III COMPLETED
Phase 3 randomized trial of elacestrant monotherapy versus standard endocrine therapy options after progression on endocrine therapy plus a CDK4/6 inhibitor.
Show evidence (1 reference)
clinicaltrials:NCT03778931 SUPPORT Human Clinical
"This Phase 3 clinical study compares the efficacy and safety of elacestrant to the standard of care (SoC) options of fulvestrant or an aromatase inhibitor (AI) in women and men with breast cancer whose disease has advanced on at least one endocrine therapy including a CDK4/6 inhibitor in..."
ClinicalTrials.gov summary establishes the EMERALD comparator design after CDK4/6 inhibitor and endocrine therapy exposure.
Sacituzumab Govitecan Versus Treatment of Physician's Choice PHASE_III ACTIVE_NOT_RECRUITING
Phase 3 trial comparing sacituzumab govitecan-hziy with physician's choice chemotherapy in HR+/HER2- metastatic breast cancer after at least two prior chemotherapy regimens.
Show evidence (1 reference)
clinicaltrials:NCT04639986 SUPPORT Human Clinical
"The goal of this study is to compare the study drug, sacituzumab govitecan-hziy, versus doctors' treatment of choice in participants with HR+/HER2- metastatic breast cancer (MBC) who have failed at least 2 prior chemotherapy regimens."
ClinicalTrials.gov summary establishes the ADC comparator trial in heavily pretreated HR+/HER2- metastatic breast cancer.
{ }

Source YAML

click to show 
name: Breast Carcinoma
creation_date: '2026-03-28T21:00:00Z'
description: >-
  Breast carcinoma is a malignant epithelial tumor of the breast whose clinical
  behavior and treatment are stratified by estrogen/progesterone receptor and
  HER2 status. The receptor-defined subsets are curated in depth in the
  separate ER_Positive_Breast_Cancer, HER2_Positive_Breast_Cancer,
  Triple_Negative_Breast_Cancer, and PIK3CA_Mutant_Breast_Cancer entries; this
  entry carries the shared breast-carcinoma biology and the metastatic stage.
  Advanced disease disseminates with particular tropism for bone, lung, brain,
  and liver; metastatic competence emerges through epithelial to mesenchymal
  transition, collective and single-cell invasion, angiogenesis, immune
  evasion, and adaptation to organ-specific microenvironments. During
  dissemination, endocrine and HER2 pathway dependence may be retained, lost,
  or reconfigured through clonal selection and receptor discordance, creating
  clinically important differences between primary and metastatic lesions.
categories:
- Breast Cancer
- Solid Tumor
parents:
- thoracic cancer
disease_term:
  preferred_term: breast carcinoma
  term:
    id: MONDO:0004989
    label: breast carcinoma
mappings:
  mondo_mappings:
  - term:
      id: MONDO:0004989
      label: breast carcinoma
    mapping_predicate: skos:exactMatch
    mapping_source: MONDO
    mapping_justification: >-
      MONDO provides an exact disease term for breast carcinoma. This entry was
      reconstituted from the former Metastatic_Breast_Carcinoma entry (cancer
      granularity ladder, design decisions §3a): stage is not a taxon, so the
      metastatic view now lives in this entry's Metastatic stage.

has_subtypes:
- name: ER-positive
  display_name: ER-Positive Breast Cancer
  description: >-
    Pointer subtype (design decisions section 3a(d)): curated in depth as the
    separate ER_Positive_Breast_Cancer entry.
- name: HER2-positive
  display_name: HER2-Positive Breast Cancer
  description: >-
    Pointer subtype: curated in depth as the separate
    HER2_Positive_Breast_Cancer entry.
- name: Triple-negative
  display_name: Triple-Negative Breast Cancer
  description: >-
    Pointer subtype: curated in depth as the separate
    Triple_Negative_Breast_Cancer entry, which carries its own MONDO term
    (MONDO:0005494).
- name: PIK3CA-mutant
  display_name: PIK3CA-Mutant Breast Cancer
  description: >-
    Pointer subtype: curated in depth as the separate
    PIK3CA_Mutant_Breast_Cancer entry.
stages:
- name: Early-stage
  description: >-
    Disease confined to the breast and regional lymph nodes, treated with
    curative intent by surgery, radiotherapy, and receptor-guided systemic
    therapy.
- name: Metastatic
  description: >-
    Advanced breast carcinoma disseminated to distant organs, with particular
    tropism for bone, lung, brain, and liver. Receptor status may differ
    between primary and metastatic lesions, and systemic therapy is selected
    by the receptor and genomic profile of the metastatic disease.
  notes: >-
    This stage carries the content of the former Metastatic_Breast_Carcinoma
    entry (cancer granularity ladder, design decisions §3a). Brain metastases
    occur in up to 30% of advanced breast cancer cases, and 5-year survival
    differs sharply by intrinsic subtype.
  evidence:
  - reference: PMID:37386445
    reference_title: "Breast cancer brain metastasis: from etiology to state-of-the-art modeling."
    supports: SUPPORT
    evidence_source: HUMAN_CLINICAL
    snippet: Brain metastases occur in as many as 30% of patients with advanced breast cancer, and the 1-year survival rate of these patients is around 20%.
    explanation: Summarizes the burden of brain dissemination in advanced breast cancer.
  - reference: PMID:36138404
    reference_title: "Long-term treatment patterns and survival in metastatic breast cancer by intrinsic subtypes - an observational cohort study in Sweden."
    supports: SUPPORT
    evidence_source: HUMAN_CLINICAL
    snippet: The 5-year survival rate was highest for HER2+/Luminal (46%) patients, followed by Luminal B (29%), Luminal A (28%), HER2+/ER- (21%), and TNBC (7%).
    explanation: Provides subtype-stratified long-term survival data for the metastatic stage.

pathophysiology:
- name: EMT-Driven Dissemination
  conforms_to: "invasion_and_metastasis#Epithelial-Mesenchymal Transition Activation"
  description: >-
    Metastatic breast carcinoma acquires motile and invasive phenotypes through epithelial
    to mesenchymal transition and related plasticity programs. EMT reduces epithelial
    adhesion, increases migratory behavior, and facilitates escape from the primary
    tumor,
    intravasation, and colonization of distant tissue niches.
  evidence:
  - reference: PMID:37386445
    reference_title: "Breast cancer brain metastasis: from etiology to state-of-the-art modeling."
    supports: SUPPORT
    evidence_source: HUMAN_CLINICAL
    snippet: The metastasis of cancer cells from the primary tumor site to other organs in the body, notably the lungs, bones, brain, and liver, is what causes breast cancer to ultimately be fatal.
    explanation: This supports the central role of distant dissemination and organotropism in lethal breast cancer.
  biological_processes:
  - preferred_term: epithelial to mesenchymal transition
    modifier: INCREASED
    term:
      id: GO:0001837
      label: epithelial to mesenchymal transition
  - preferred_term: cell migration
    modifier: INCREASED
    term:
      id: GO:0016477
      label: cell migration
  - preferred_term: positive regulation of cell migration
    modifier: INCREASED
    term:
      id: GO:0030335
      label: positive regulation of cell migration
  downstream:
  - target: Organ-Specific Tropism
    description: >-
      Cells that have escaped the primary tumour through EMT-like plasticity
      colonise distant sites in the seed-and-soil pattern characteristic of breast
      carcinoma.
- name: Organ-Specific Tropism
  conforms_to: "invasion_and_metastasis#Metastatic Colonization"
  description: >-
    Breast cancer metastases display seed-and-soil behavior, with preferential colonization
    of bone, lung, brain, and liver. This reflects both intrinsic tumor programs and
    permissive microenvironments, including osteotropic signaling in bone, vascular
    adaptation in lung, and blood-brain barrier traversal in brain metastasis.
  evidence:
  - reference: PMID:37386445
    reference_title: "Breast cancer brain metastasis: from etiology to state-of-the-art modeling."
    supports: SUPPORT
    evidence_source: HUMAN_CLINICAL
    snippet: The metastasis of cancer cells from the primary tumor site to other organs in the body, notably the lungs, bones, brain, and liver, is what causes breast cancer to ultimately be fatal.
    explanation: This directly supports the dominant distant sites highlighted in metastatic breast cancer.
  biological_processes:
  - preferred_term: cell migration
    modifier: INCREASED
    term:
      id: GO:0016477
      label: cell migration
  downstream:
  - target: Immune Evasion in Metastatic Niches
    description: >-
      Disseminated cells adapt to organ-specific immune milieus, recruiting
      suppressive populations that let metastatic clones persist.
  - target: Angiogenic Outgrowth
    description: >-
      Micrometastatic foci in bone, lung, brain and liver require neovascular
      support to survive and expand.
- name: ER and HER2 Receptor Heterogeneity
  description: >-
    Intratumoral spatial heterogeneity in estrogen receptor (ER), progesterone receptor
    (PR),
    and HER2 expression occurs in a meaningful subset of breast tumors, with biomarker
    status
    differing between sampled regions of the same tumor. This heterogeneity affects
    breast
    cancer classification accuracy from biopsy sampling and has clinical implications
    for
    selecting endocrine and HER2-targeted therapy.
  evidence:
  - reference: PMID:27349894
    reference_title: "Intratumoral heterogeneity as a source of discordance in breast cancer biomarker classification."
    supports: SUPPORT
    evidence_source: HUMAN_CLINICAL
    snippet: Intratumoral biomarker heterogeneity may impact breast cancer classification accuracy, with implications for clinical management.
    explanation: This supports clinically meaningful intratumoral ER/PR/HER2 heterogeneity within primary breast cancers, affecting biomarker-based classification and treatment selection.
  biological_processes:
  - preferred_term: estrogen receptor signaling pathway
    modifier: ABNORMAL
    term:
      id: GO:0030520
      label: estrogen receptor signaling pathway
  - preferred_term: cell surface receptor protein tyrosine kinase signaling pathway
    modifier: ABNORMAL
    term:
      id: GO:0007169
      label: cell surface receptor protein tyrosine kinase signaling pathway
- name: Angiogenic Outgrowth
  description: >-
    Successful metastatic colonization requires neovascular support both at the primary
    site and in distant lesions. Angiogenesis promotes survival of micrometastatic
    foci,
    sustains growth in bone and lung deposits, and supports blood-brain barrier adaptation
    in brain metastases.
  biological_processes:
  - preferred_term: angiogenesis
    modifier: INCREASED
    term:
      id: GO:0001525
      label: angiogenesis
- name: Immune Evasion in Metastatic Niches
  description: >-
    Disseminated breast cancer cells evade immune elimination by remodeling cytokine
    gradients, recruiting suppressive myeloid and lymphoid populations, and adapting
    to
    organ-specific immune milieus. These programs help metastatic clones persist despite
    host antitumor surveillance and systemic therapy.
  biological_processes:
  - preferred_term: negative regulation of immune response
    modifier: INCREASED
    term:
      id: GO:0050777
      label: negative regulation of immune response
phenotypes:
- category: Neurologic
  name: Headache
  frequency: FREQUENT
  description: Brain metastases often present with headache from edema or mass effect.
  phenotype_term:
    preferred_term: Headache
    term:
      id: HP:0002315
      label: Headache
- category: Respiratory
  name: Dyspnea
  frequency: FREQUENT
  description: Dyspnea can reflect pulmonary metastases, pleural involvement, or treatment-related cardiopulmonary compromise.
  phenotype_term:
    preferred_term: Dyspnea
    term:
      id: HP:0002094
      label: Dyspnea
- category: Musculoskeletal
  name: Bone pain
  frequency: VERY_FREQUENT
  description: Bone-tropic metastases commonly produce pain, impending fracture risk, and spinal instability.
  phenotype_term:
    preferred_term: Bone pain
    term:
      id: HP:0002653
      label: Bone pain
- category: Constitutional
  name: Fatigue
  frequency: VERY_FREQUENT
  description: Fatigue reflects systemic inflammatory burden, anemia, treatment toxicity, and advanced metastatic disease.
  phenotype_term:
    preferred_term: Fatigue
    term:
      id: HP:0012378
      label: Fatigue
- category: Constitutional
  name: Weight loss
  frequency: FREQUENT
  description: Progressive metastatic disease often causes anorexia, catabolism, and cancer-associated weight loss.
  phenotype_term:
    preferred_term: Weight loss
    term:
      id: HP:0001824
      label: Weight loss
treatments:
- name: CDK4/6 Inhibitor Plus Endocrine Therapy
  description: >-
    HR-positive, HER2-negative metastatic breast carcinoma is commonly treated
    with endocrine therapy combined with a CDK4/6 inhibitor, using aromatase
    inhibitor or fulvestrant backbones selected by treatment history and
    resistance profile.
  treatment_term:
    preferred_term: Pharmacotherapy
    term:
      id: NCIT:C15986
      label: Pharmacotherapy
    therapeutic_agent:
    - preferred_term: palbociclib
      term:
        id: CHEBI:85993
        label: palbociclib
    - preferred_term: fulvestrant
      term:
        id: CHEBI:31638
        label: fulvestrant
  evidence:
  - reference: DOI:10.1007/s10549-024-07376-w
    reference_title: 'Comprehensive genomic profiling of ESR1, PIK3CA, AKT1, and PTEN in HR(+)HER2(−) metastatic breast cancer: prevalence along treatment course and predictive value for endocrine therapy resistance in real-world practice'
    supports: SUPPORT
    evidence_source: HUMAN_CLINICAL
    snippet: Patients receiving 1st-line aromatase inhibitor + CDK4/6 inhibitor (n = 573) with ESR1mut had less favorable rwPFS and rwOS versus ESR1 wild-type; no differences were observed for fulvestrant + CDK4/6 inhibitor (n = 348).
    explanation: >-
      Real-world metastatic HR+/HER2- cohorts document aromatase-inhibitor and
      fulvestrant backbones paired with CDK4/6 inhibitors in first-line therapy.
  - reference: PMID:41744884
    reference_title: Romanian Consensus Statement for Hormone Receptor-Positive and Human Epidermal Growth Factor Receptor 2-Negative Metastatic Breast Cancer (HR+/HER2- mBC) and Triple-Negative Metastatic Breast Cancer (mTNBC).
    supports: SUPPORT
    evidence_source: OTHER
    snippet: "for HR+/HER2- mBC, first-line endocrine therapy plus CDK4/6 inhibitor, followed by targeted agents, chemotherapy, or antibody-drug conjugates based on progression and visceral crisis"
    explanation: The Romanian consensus statement recommends first-line endocrine therapy plus a CDK4/6 inhibitor for HR-positive/HER2-negative metastatic breast cancer.
- name: Elacestrant Oral SERD for ESR1-Mutated Disease
  description: >-
    Elacestrant is an oral selective estrogen receptor degrader used after prior
    endocrine therapy for ER-positive, HER2-negative metastatic breast carcinoma
    with ESR1 mutations.
  treatment_term:
    preferred_term: Pharmacotherapy
    term:
      id: NCIT:C15986
      label: Pharmacotherapy
    therapeutic_agent:
    - preferred_term: elacestrant
      term:
        id: CHEBI:229213
        label: elacestrant
  evidence:
  - reference: DOI:10.1200/jco.23.02112
    reference_title: 'US Food and Drug Administration Approval Summary: Elacestrant for Estrogen Receptor–Positive, Human Epidermal Growth Factor Receptor 2–Negative, <i>ESR1</i>-Mutated Advanced or Metastatic Breast Cancer'
    supports: SUPPORT
    evidence_source: HUMAN_CLINICAL
    snippet: The US Food and Drug Administration (FDA) approved elacestrant for the treatment of postmenopausal women or adult men with estrogen receptor–positive (ER+), human epidermal growth factor receptor 2–negative (HER2–), estrogen receptor 1 ( ESR1)–mutated advanced or metastatic breast cancer with disease progression after at least one line of endocrine therapy (ET).
    explanation: FDA approval summary supports elacestrant for ESR1-mutated ER+/HER2- advanced or metastatic breast cancer after endocrine therapy.
- name: Capivasertib Plus Fulvestrant for PI3K/AKT/PTEN-Altered Disease
  description: >-
    Capivasertib plus fulvestrant targets AKT-pathway dependence in HR-positive,
    HER2-negative metastatic breast carcinoma with PIK3CA, AKT1, or PTEN
    alterations after progression on endocrine therapy.
  treatment_term:
    preferred_term: Pharmacotherapy
    term:
      id: NCIT:C15986
      label: Pharmacotherapy
    therapeutic_agent:
    - preferred_term: capivasertib
      term:
        id: CHEBI:229222
        label: capivasertib
    - preferred_term: fulvestrant
      term:
        id: CHEBI:31638
        label: fulvestrant
  evidence:
  - reference: clinicaltrials:NCT04305496
    reference_title: "A Phase III Double-blind Randomised Study Assessing the Efficacy and Safety of Capivasertib + Fulvestrant Versus Placebo + Fulvestrant as Treatment for Locally Advanced (Inoperable) or Metastatic Hormone Receptor Positive, Human Epidermal Growth Factor Receptor 2 Negative (HR+/HER2-) Breast Cancer Following Recurrence or Progression On or After Treatment With an Aromatase Inhibitor"
    supports: SUPPORT
    evidence_source: HUMAN_CLINICAL
    snippet: Phase III, double-blind, randomised study assessing the efficacy of capivasertib + fulvestrant vs placebo + fulvestrant for the treatment of patients with locally advanced (inoperable) or metastatic HR+/HER2- breast cancer following recurrence or progression on or after AI therapy.
    explanation: CAPItello-291 directly evaluates capivasertib plus fulvestrant in locally advanced or metastatic HR+/HER2- breast cancer after aromatase-inhibitor progression.
- name: PARP Inhibitors for Germline BRCA-Mutated Disease
  description: >-
    PARP inhibitors exploit homologous recombination deficiency in metastatic
    breast carcinoma with germline BRCA1 or BRCA2 pathogenic variants.
  treatment_term:
    preferred_term: targeted therapy
    term:
      id: NCIT:C93352
      label: Targeted Therapy
    therapeutic_agent:
    - preferred_term: olaparib
      term:
        id: CHEBI:83766
        label: olaparib
    - preferred_term: talazoparib
      term:
        id: CHEBI:231344
        label: talazoparib
  evidence:
  - reference: DOI:10.1038/s41416-024-02827-z
    reference_title: 'BRCA-mutated breast cancer: the unmet need, challenges and therapeutic benefits of genetic testing'
    supports: SUPPORT
    evidence_source: HUMAN_CLINICAL
    snippet: BC resulting from a germline BRCAm (gBRCAm) has distinct clinical characteristics along with increased sensitivity to DNA-damaging agents such as poly(ADP-ribose) polymerase (PARP) inhibitors and platinum-based chemotherapies, and potentially decreased sensitivity to cyclin-dependent kinase 4 and 6 (CDK4/6) inhibitors.
    explanation: Review-level evidence supports PARP inhibitor sensitivity in germline BRCA-mutated breast cancer, including advanced-disease treatment planning.
- name: Trastuzumab Deruxtecan for HER2-Positive or HER2-Low Disease
  description: >-
    Trastuzumab deruxtecan is an antibody-drug conjugate used for metastatic
    breast carcinoma with HER2-positive or HER2-low expression after appropriate
    prior therapy.
  treatment_term:
    preferred_term: immunotherapy
    term:
      id: NCIT:C15262
      label: Immunotherapy
    therapeutic_agent:
    - preferred_term: trastuzumab deruxtecan
      term:
        id: NCIT:C128799
        label: Trastuzumab Deruxtecan
  evidence:
  - reference: DOI:10.3390/cancers17213505
    reference_title: 'Trastuzumab–Deruxtecan for the Treatment of Metastatic Breast Cancer Patients: Data from Real World Studies'
    supports: SUPPORT
    evidence_source: HUMAN_CLINICAL
    snippet: Trastuzumab–deruxtecan (T-DXd), a new-generation antibody drug conjugate, has greatly improved the survival and clinical benefit rates of patients affected by advanced HER2-positive/HER2-low breast cancer according to the results of controlled clinical trials with a manageable safety profile.
    explanation: This review summarizes T-DXd benefit for advanced HER2-positive and HER2-low metastatic breast cancer.
- name: Sacituzumab Govitecan Antibody-Drug Conjugate
  description: >-
    Sacituzumab govitecan is a Trop-2-directed antibody-drug conjugate used for
    metastatic breast carcinoma after prior systemic therapy, including
    HR-positive/HER2-negative disease after multiple chemotherapy regimens.
  treatment_term:
    preferred_term: Pharmacotherapy
    term:
      id: NCIT:C15986
      label: Pharmacotherapy
    therapeutic_agent:
    - preferred_term: sacituzumab govitecan
      term:
        id: NCIT:C102783
        label: Sacituzumab Govitecan
  evidence:
  - reference: clinicaltrials:NCT04639986
    reference_title: "A Phase 3 Asian Study of Sacituzumab Govitecan (IMMU-132) Versus Treatment of Physician's Choice (TPC) in Subjects With Hormonal Receptor-positive (HR+)/Human Epidermal Growth Factor Receptor 2 Negative (HER2-) Metastatic Breast Cancer (MBC) Who Have Failed at Least 2 Prior Chemotherapy Regimens"
    supports: SUPPORT
    evidence_source: HUMAN_CLINICAL
    snippet: The goal of this study is to compare the study drug, sacituzumab govitecan-hziy, versus doctors' treatment of choice in participants with HR+/HER2- metastatic breast cancer (MBC) who have failed at least 2 prior chemotherapy regimens.
    explanation: The phase 3 record supports sacituzumab govitecan evaluation in heavily pretreated HR+/HER2- metastatic breast cancer.
clinical_trials:
- name: CAPItello-291
  phase: PHASE_III
  status: ACTIVE_NOT_RECRUITING
  description: >-
    Phase 3 randomized study of capivasertib plus fulvestrant versus placebo plus
    fulvestrant in locally advanced or metastatic HR+/HER2- breast cancer after
    recurrence or progression on aromatase-inhibitor therapy.
  evidence:
  - reference: clinicaltrials:NCT04305496
    reference_title: "A Phase III Double-blind Randomised Study Assessing the Efficacy and Safety of Capivasertib + Fulvestrant Versus Placebo + Fulvestrant as Treatment for Locally Advanced (Inoperable) or Metastatic Hormone Receptor Positive, Human Epidermal Growth Factor Receptor 2 Negative (HR+/HER2-) Breast Cancer Following Recurrence or Progression On or After Treatment With an Aromatase Inhibitor"
    supports: SUPPORT
    evidence_source: HUMAN_CLINICAL
    snippet: Phase III, double-blind, randomised study assessing the efficacy of capivasertib + fulvestrant vs placebo + fulvestrant for the treatment of patients with locally advanced (inoperable) or metastatic HR+/HER2- breast cancer following recurrence or progression on or after AI therapy.
    explanation: ClinicalTrials.gov summary establishes the CAPItello-291 regimen and metastatic HR+/HER2- population.
- name: EMERALD
  phase: PHASE_III
  status: COMPLETED
  description: >-
    Phase 3 randomized trial of elacestrant monotherapy versus standard endocrine
    therapy options after progression on endocrine therapy plus a CDK4/6
    inhibitor.
  evidence:
  - reference: clinicaltrials:NCT03778931
    reference_title: "Elacestrant Monotherapy vs. Standard of Care for the Treatment of Patients With ER+/HER2- Advanced Breast Cancer Following CDK4/6 Inhibitor Therapy: A Phase 3 Randomized, Open-label, Active-controlled, Multicenter Trial"
    supports: SUPPORT
    evidence_source: HUMAN_CLINICAL
    snippet: This Phase 3 clinical study compares the efficacy and safety of elacestrant to the standard of care (SoC) options of fulvestrant or an aromatase inhibitor (AI) in women and men with breast cancer whose disease has advanced on at least one endocrine therapy including a CDK4/6 inhibitor in combination with fulvestrant or an aromatase inhibitor (AI).
    explanation: ClinicalTrials.gov summary establishes the EMERALD comparator design after CDK4/6 inhibitor and endocrine therapy exposure.
- name: Sacituzumab Govitecan Versus Treatment of Physician's Choice
  phase: PHASE_III
  status: ACTIVE_NOT_RECRUITING
  description: >-
    Phase 3 trial comparing sacituzumab govitecan-hziy with physician's choice
    chemotherapy in HR+/HER2- metastatic breast cancer after at least two prior
    chemotherapy regimens.
  evidence:
  - reference: clinicaltrials:NCT04639986
    reference_title: "A Phase 3 Asian Study of Sacituzumab Govitecan (IMMU-132) Versus Treatment of Physician's Choice (TPC) in Subjects With Hormonal Receptor-positive (HR+)/Human Epidermal Growth Factor Receptor 2 Negative (HER2-) Metastatic Breast Cancer (MBC) Who Have Failed at Least 2 Prior Chemotherapy Regimens"
    supports: SUPPORT
    evidence_source: HUMAN_CLINICAL
    snippet: The goal of this study is to compare the study drug, sacituzumab govitecan-hziy, versus doctors' treatment of choice in participants with HR+/HER2- metastatic breast cancer (MBC) who have failed at least 2 prior chemotherapy regimens.
    explanation: ClinicalTrials.gov summary establishes the ADC comparator trial in heavily pretreated HR+/HER2- metastatic breast cancer.
genetic:
- name: ESR1
  gene_term:
    preferred_term: ESR1
    term:
      id: hgnc:3467
      label: ESR1
  association: Acquired endocrine resistance mutation
  notes: >-
    ESR1 ligand-binding domain mutations emerge during metastatic endocrine therapy
    and
    permit ligand-independent ER signaling.
- name: ERBB2 (HER2)
  association: Amplification or overexpression
  notes: >-
    HER2 amplification supports aggressive dissemination and remains a major therapeutic
    dependency in a subset of metastatic lesions.
- name: PIK3CA
  gene_term:
    preferred_term: PIK3CA
    term:
      id: hgnc:8975
      label: PIK3CA
  association: Somatic activating mutation
  notes: >-
    PIK3CA hotspot mutations promote survival signaling, metastatic fitness, and partial
    resistance to endocrine and HER2-directed therapies.
- name: TP53
  gene_term:
    preferred_term: TP53
    term:
      id: hgnc:11998
      label: TP53
  association: Somatic loss of function
  notes: >-
    TP53 disruption facilitates genomic instability and metastatic clonal evolution,
    especially
    in aggressive HER2-positive and triple-negative disease.
environmental:
- name: Obesity
  notes: Obesity increases inflammatory and endocrine signals that can promote recurrence and metastatic progression.
  evidence:
  - reference: PMID:35579841
    reference_title: "Associations of adiposity and weight change with recurrence and survival in breast cancer patients: a systematic review and meta-analysis."
    supports: SUPPORT
    evidence_source: HUMAN_CLINICAL
    snippet: "the summary relative risk (RR) for obese women was 1.21 (1.15-1.27) for all-cause mortality, 1.22 (1.13-1.32) for BCSM, 1.12 (1.06-1.18) for recurrence, and 1.19 (1.11-1.28) for distant recurrence"
    explanation: Meta-analysis of prospective cohorts quantifies obesity's association with breast cancer recurrence and distant recurrence.
- name: Alcohol exposure
  exposure_term:
    preferred_term: exposure to alcohol consumption
    term:
      id: ECTO:0001082
      label: exposure to alcohol consumption
  notes: Alcohol contributes to breast cancer risk and may amplify metastatic recurrence risk through endocrine and inflammatory effects.
  evidence:
  - reference: PMID:32090238
    reference_title: "Alcohol Consumption by Beverage Type and Risk of Breast Cancer: A Dose-Response Meta-Analysis of Prospective Cohort Studies."
    supports: SUPPORT
    evidence_source: HUMAN_CLINICAL
    snippet: "when adding 10 g per day, the risk increased by 10.5% (RR = 1.10, 95%CI = 1.08-1.13) in total alcohol and 8.9% (RR = 1.08, 95%CI = 1.04-1.14) in wine"
    explanation: Dose-response meta-analysis of prospective cohorts quantifies alcohol's contribution to breast cancer risk.
notes: >-
  Requested NCIT cross-reference: NCIT:C153238 (for the metastatic stage;
  NCIT:C4872 is breast carcinoma). The dominant metastatic biology is
  driven by EMT, receptor plasticity, angiogenesis, immune evasion, and organotropism
  to bone, lung, brain, and liver.
references:
- reference: clinicaltrials:NCT04305496
  title: A Phase III Double-blind Randomised Study Assessing the Efficacy and Safety of Capivasertib + Fulvestrant Versus Placebo + Fulvestrant as Treatment for Locally Advanced (Inoperable) or Metastatic Hormone Receptor Positive, Human Epidermal Growth Factor Receptor 2 Negative (HR+/HER2-) Breast Cancer Following Recurrence or Progression On or After Treatment With an Aromatase Inhibitor
  findings: []
- reference: clinicaltrials:NCT03778931
  title: 'Elacestrant Monotherapy vs. Standard of Care for the Treatment of Patients With ER+/HER2- Advanced Breast Cancer Following CDK4/6 Inhibitor Therapy: A Phase 3 Randomized, Open-label, Active-controlled, Multicenter Trial'
  findings: []
- reference: clinicaltrials:NCT04639986
  title: A Phase 3 Asian Study of Sacituzumab Govitecan (IMMU-132) Versus Treatment of Physician's Choice (TPC) in Subjects With Hormonal Receptor-positive (HR+)/Human Epidermal Growth Factor Receptor 2 Negative (HER2-) Metastatic Breast Cancer (MBC) Who Have Failed at Least 2 Prior Chemotherapy Regimens
  findings: []
- reference: DOI:10.1007/s10549-024-07376-w
  title: 'Comprehensive genomic profiling of ESR1, PIK3CA, AKT1, and PTEN in HR(+)HER2(−) metastatic breast cancer: prevalence along treatment course and predictive value for endocrine therapy resistance in real-world practice'
  found_in:
  - Metastatic_Breast_Carcinoma-deep-research-falcon.md
  findings:
  - statement: The treatment landscape for HR(+)HER2(−) metastatic breast cancer (MBC) is evolving for patients with ESR1 mutations (mut) and PI3K/AKT pathway genomic alterations (GA).
    supporting_text: The treatment landscape for HR(+)HER2(−) metastatic breast cancer (MBC) is evolving for patients with ESR1 mutations (mut) and PI3K/AKT pathway genomic alterations (GA).
    evidence:
    - reference: DOI:10.1007/s10549-024-07376-w
      reference_title: 'Comprehensive genomic profiling of ESR1, PIK3CA, AKT1, and PTEN in HR(+)HER2(−) metastatic breast cancer: prevalence along treatment course and predictive value for endocrine therapy resistance in real-world practice'
      supports: SUPPORT
      evidence_source: HUMAN_CLINICAL
      snippet: The treatment landscape for HR(+)HER2(−) metastatic breast cancer (MBC) is evolving for patients with ESR1 mutations (mut) and PI3K/AKT pathway genomic alterations (GA).
      explanation: Deep research cited this publication as relevant literature for Metastatic Breast Carcinoma.
- reference: DOI:10.1007/s10549-024-07469-6
  title: 'Trends in HR+ metastatic breast cancer survival before and after CDK4/6 inhibitor introduction in the United States: a SEER registry analysis of patients with HER2− and HER2+ metastatic breast cancer'
  found_in:
  - Metastatic_Breast_Carcinoma-deep-research-falcon.md
  findings:
  - statement: 'Trends in HR+ metastatic breast cancer survival before and after CDK4/6 inhibitor introduction in the United States: a SEER registry analysis of patients with HER2− and HER2+ metastatic breast cancer'
    supporting_text: 'Trends in HR+ metastatic breast cancer survival before and after CDK4/6 inhibitor introduction in the United States: a SEER registry analysis of patients with HER2− and HER2+ metastatic breast cancer'
- reference: DOI:10.1016/j.esmoop.2024.104083
  title: 'Use and outcomes of trastuzumab deruxtecan in HER2-positive and HER2-low metastatic breast cancer in a real-world setting: a nationwide cohort study'
  found_in:
  - Metastatic_Breast_Carcinoma-deep-research-falcon.md
  findings:
  - statement: 'Use and outcomes of trastuzumab deruxtecan in HER2-positive and HER2-low metastatic breast cancer in a real-world setting: a nationwide cohort study'
    supporting_text: 'Use and outcomes of trastuzumab deruxtecan in HER2-positive and HER2-low metastatic breast cancer in a real-world setting: a nationwide cohort study'
- reference: DOI:10.1038/s41591-024-03269-z
  title: 'Sacituzumab govitecan in HR+HER2− metastatic breast cancer: the randomized phase 3 EVER-132-002 trial'
  found_in:
  - Metastatic_Breast_Carcinoma-deep-research-falcon.md
  findings:
  - statement: 'Sacituzumab govitecan in HR+HER2− metastatic breast cancer: the randomized phase 3 EVER-132-002 trial'
    supporting_text: 'Sacituzumab govitecan in HR+HER2− metastatic breast cancer: the randomized phase 3 EVER-132-002 trial'
- reference: DOI:10.1038/s41598-025-12883-x
  title: Patterns and prognostic implications of distant metastasis in breast Cancer based on SEER population data
  found_in:
  - Metastatic_Breast_Carcinoma-deep-research-falcon.md
  findings:
  - statement: Distant metastasis remains the leading cause of mortality in breast cancer, yet comprehensive population-based evaluations of metastatic site combinations and their survival implications are limited.
    supporting_text: Distant metastasis remains the leading cause of mortality in breast cancer, yet comprehensive population-based evaluations of metastatic site combinations and their survival implications are limited.
    evidence:
    - reference: DOI:10.1038/s41598-025-12883-x
      reference_title: Patterns and prognostic implications of distant metastasis in breast Cancer based on SEER population data
      supports: SUPPORT
      evidence_source: HUMAN_CLINICAL
      snippet: Distant metastasis remains the leading cause of mortality in breast cancer, yet comprehensive population-based evaluations of metastatic site combinations and their survival implications are limited.
      explanation: Deep research cited this publication as relevant literature for Metastatic Breast Carcinoma.
- reference: DOI:10.1056/nejmoa2214131
  title: Capivasertib in Hormone Receptor–Positive Advanced Breast Cancer
  found_in:
  - Metastatic_Breast_Carcinoma-deep-research-falcon.md
  findings:
  - statement: Capivasertib in Hormone Receptor–Positive Advanced Breast Cancer
    supporting_text: Capivasertib in Hormone Receptor–Positive Advanced Breast Cancer
- reference: DOI:10.1186/s12885-025-14786-6
  title: Epidemiology and outcomes associated with brain metastases among patients with metastatic breast cancer – a cohort study in US electronic health record data
  found_in:
  - Metastatic_Breast_Carcinoma-deep-research-falcon.md
  findings:
  - statement: Epidemiology and outcomes associated with brain metastases among patients with metastatic breast cancer – a cohort study in US electronic health record data
    supporting_text: There are limited real-world data on the prevalence of brain metastases (BM) in metastatic breast cancer (mBC) across the treatment pathway, especially when stratified by human epidermal growth factor receptor 2–positive (HER2+) or HER2–negative (HER2−) status.
    evidence:
    - reference: DOI:10.1186/s12885-025-14786-6
      reference_title: Epidemiology and outcomes associated with brain metastases among patients with metastatic breast cancer – a cohort study in US electronic health record data
      supports: SUPPORT
      evidence_source: OTHER
      snippet: There are limited real-world data on the prevalence of brain metastases (BM) in metastatic breast cancer (mBC) across the treatment pathway, especially when stratified by human epidermal growth factor receptor 2–positive (HER2+) or HER2–negative (HER2−) status.
      explanation: Deep research cited this publication as relevant literature for Metastatic Breast Carcinoma.
- reference: DOI:10.1200/jco.23.02112
  title: 'US Food and Drug Administration Approval Summary: Elacestrant for Estrogen Receptor–Positive, Human Epidermal Growth Factor Receptor 2–Negative, <i>ESR1</i>-Mutated Advanced or Metastatic Breast Cancer'
  found_in:
  - Metastatic_Breast_Carcinoma-deep-research-falcon.md
  findings:
  - statement: 'US Food and Drug Administration Approval Summary: Elacestrant for Estrogen Receptor–Positive, Human Epidermal Growth Factor Receptor 2–Negative, <i>ESR1</i>-Mutated Advanced or Metastatic Breast Cancer'
    supporting_text: The US Food and Drug Administration (FDA) approved elacestrant for the treatment of postmenopausal women or adult men with estrogen receptor–positive (ER+), human epidermal growth factor receptor 2–negative (HER2–), estrogen receptor 1 ( ESR1)–mutated advanced or metastatic breast cancer with disease progression after at least one line of endocrine therapy (ET).
    evidence:
    - reference: DOI:10.1200/jco.23.02112
      reference_title: 'US Food and Drug Administration Approval Summary: Elacestrant for Estrogen Receptor–Positive, Human Epidermal Growth Factor Receptor 2–Negative, <i>ESR1</i>-Mutated Advanced or Metastatic Breast Cancer'
      supports: SUPPORT
      evidence_source: HUMAN_CLINICAL
      snippet: The US Food and Drug Administration (FDA) approved elacestrant for the treatment of postmenopausal women or adult men with estrogen receptor–positive (ER+), human epidermal growth factor receptor 2–negative (HER2–), estrogen receptor 1 ( ESR1)–mutated advanced or metastatic breast cancer with disease progression after at least one line of endocrine therapy (ET).
      explanation: Deep research cited this publication as relevant literature for Metastatic Breast Carcinoma.
- reference: DOI:10.33590/oncolamj/ctrc4560
  title: 'Updates in Advanced Hormone Receptor-Positive Breast Cancer: From Circulating Tumor DNA-Guided Therapy to Precision Medicine'
  found_in:
  - Metastatic_Breast_Carcinoma-deep-research-falcon.md
  findings:
  - statement: The therapeutic landscape for hormone receptor-positive (HR+) advanced breast cancer (BC) is moving from generalized endocrine therapies to highly targeted, biomarker-driven strategies.
    supporting_text: The therapeutic landscape for hormone receptor-positive (HR+) advanced breast cancer (BC) is moving from generalized endocrine therapies to highly targeted, biomarker-driven strategies.
    evidence:
    - reference: DOI:10.33590/oncolamj/ctrc4560
      reference_title: 'Updates in Advanced Hormone Receptor-Positive Breast Cancer: From Circulating Tumor DNA-Guided Therapy to Precision Medicine'
      supports: SUPPORT
      evidence_source: HUMAN_CLINICAL
      snippet: The therapeutic landscape for hormone receptor-positive (HR+) advanced breast cancer (BC) is moving from generalized endocrine therapies to highly targeted, biomarker-driven strategies.
      explanation: Deep research cited this publication as relevant literature for Metastatic Breast Carcinoma.
- reference: DOI:10.3389/fendo.2023.1184895
  title: 'Patterns of de novo metastasis and survival outcomes by age in breast cancer patients: a SEER population-based study'
  found_in:
  - Metastatic_Breast_Carcinoma-deep-research-falcon.md
  findings:
  - statement: The role of age in metastatic disease, including breast cancer, remains obscure.
    supporting_text: The role of age in metastatic disease, including breast cancer, remains obscure.
    evidence:
    - reference: DOI:10.3389/fendo.2023.1184895
      reference_title: 'Patterns of de novo metastasis and survival outcomes by age in breast cancer patients: a SEER population-based study'
      supports: SUPPORT
      evidence_source: HUMAN_CLINICAL
      snippet: The role of age in metastatic disease, including breast cancer, remains obscure.
      explanation: Deep research cited this publication as relevant literature for Metastatic Breast Carcinoma.
- reference: DOI:10.3390/cancers17213505
  title: 'Trastuzumab–Deruxtecan for the Treatment of Metastatic Breast Cancer Patients: Data from Real World Studies'
  found_in:
  - Metastatic_Breast_Carcinoma-deep-research-falcon.md
  findings:
  - statement: 'Trastuzumab–Deruxtecan for the Treatment of Metastatic Breast Cancer Patients: Data from Real World Studies'
    supporting_text: Trastuzumab–deruxtecan (T-DXd), a new-generation antibody drug conjugate, has greatly improved the survival and clinical benefit rates of patients affected by advanced HER2-positive/HER2-low breast cancer according to the results of controlled clinical trials with a manageable safety profile.
    evidence:
    - reference: DOI:10.3390/cancers17213505
      reference_title: 'Trastuzumab–Deruxtecan for the Treatment of Metastatic Breast Cancer Patients: Data from Real World Studies'
      supports: SUPPORT
      evidence_source: HUMAN_CLINICAL
      snippet: Trastuzumab–deruxtecan (T-DXd), a new-generation antibody drug conjugate, has greatly improved the survival and clinical benefit rates of patients affected by advanced HER2-positive/HER2-low breast cancer according to the results of controlled clinical trials with a manageable safety profile.
      explanation: Deep research cited this publication as relevant literature for Metastatic Breast Carcinoma.
- reference: DOI:10.3390/curroncol32010001
  title: The Real-World Clinical Outcomes of Heavily Pretreated HER2+ and HER2-Low Metastatic Breast Cancer Patients Treated with Trastuzumab Deruxtecan at a Single Centre
  found_in:
  - Metastatic_Breast_Carcinoma-deep-research-falcon.md
  findings:
  - statement: Trastuzumab deruxtecan (TDXd) is an antibody–drug conjugate that has demonstrated impressive activity in randomized controlled clinical trials in the context of patients with HER2-amplified and HER2-low metastatic breast cancer.
    supporting_text: Trastuzumab deruxtecan (TDXd) is an antibody–drug conjugate that has demonstrated impressive activity in randomized controlled clinical trials in the context of patients with HER2-amplified and HER2-low metastatic breast cancer.
    evidence:
    - reference: DOI:10.3390/curroncol32010001
      reference_title: The Real-World Clinical Outcomes of Heavily Pretreated HER2+ and HER2-Low Metastatic Breast Cancer Patients Treated with Trastuzumab Deruxtecan at a Single Centre
      supports: SUPPORT
      evidence_source: HUMAN_CLINICAL
      snippet: Trastuzumab deruxtecan (TDXd) is an antibody–drug conjugate that has demonstrated impressive activity in randomized controlled clinical trials in the context of patients with HER2-amplified and HER2-low metastatic breast cancer.
      explanation: Deep research cited this publication as relevant literature for Metastatic Breast Carcinoma.
discussions:
- discussion_id: gap_breast_carcinoma_primary_tumour_mechanism
  prompt: >-
    What are the primary-tumour mechanisms of breast carcinoma - ductal epithelial
    transformation, DCIS-to-invasive progression, and the receptor-pathway biology
    that defines the major subtypes - and how do they connect to the metastatic
    mechanisms this entry already models?
  kind: KNOWLEDGE_GAP
  status: OPEN
  attaches_to:
  - pathophysiology#
  - stages#Early-stage
  rationale: >-
    This entry was reconstituted from the former Metastatic_Breast_Carcinoma entry
    under the cancer granularity ladder (design decisions section 3a). The
    pathophysiology it inherited is metastasis biology plus receptor heterogeneity,
    so the Early-stage stage carries no mechanism content: ductal epithelial
    transformation, DCIS-to-invasive progression, and the ER/HER2 pathway biology
    that drives the receptor-defined subtypes are not modeled here. Those subtypes
    are curated in their own entries (see has_subtypes pointers), but the shared
    primary-tumour chain that would sit above them is a genuine gap in this base
    entry rather than content deliberately delegated.
📚

References & Deep Research

References

15
clinicaltrials:NCT04305496
A Phase III Double-blind Randomised Study Assessing the Efficacy and Safety of Capivasertib + Fulvestrant Versus Placebo + Fulvestrant as Treatment for Locally Advanced (Inoperable) or Metastatic Hormone Receptor Positive, Human Epidermal Growth Factor Receptor 2 Negative (HR+/HER2-) Breast Cancer Following Recurrence or Progression On or After Treatment With an Aromatase Inhibitor
No top-level findings curated for this source.
clinicaltrials:NCT03778931
Elacestrant Monotherapy vs. Standard of Care for the Treatment of Patients With ER+/HER2- Advanced Breast Cancer Following CDK4/6 Inhibitor Therapy: A Phase 3 Randomized, Open-label, Active-controlled, Multicenter Trial
No top-level findings curated for this source.
clinicaltrials:NCT04639986
A Phase 3 Asian Study of Sacituzumab Govitecan (IMMU-132) Versus Treatment of Physician's Choice (TPC) in Subjects With Hormonal Receptor-positive (HR+)/Human Epidermal Growth Factor Receptor 2 Negative (HER2-) Metastatic Breast Cancer (MBC) Who Have Failed at Least 2 Prior Chemotherapy Regimens
No top-level findings curated for this source.
DOI:10.1007/s10549-024-07376-w
Comprehensive genomic profiling of ESR1, PIK3CA, AKT1, and PTEN in HR(+)HER2(−) metastatic breast cancer: prevalence along treatment course and predictive value for endocrine therapy resistance in real-world practice
1 finding
The treatment landscape for HR(+)HER2(−) metastatic breast cancer (MBC) is evolving for patients with ESR1 mutations (mut) and PI3K/AKT pathway genomic alterations (GA).
"The treatment landscape for HR(+)HER2(−) metastatic breast cancer (MBC) is evolving for patients with ESR1 mutations (mut) and PI3K/AKT pathway genomic alterations (GA)."
Show evidence (1 reference)
DOI:10.1007/s10549-024-07376-w SUPPORT Human Clinical
"The treatment landscape for HR(+)HER2(−) metastatic breast cancer (MBC) is evolving for patients with ESR1 mutations (mut) and PI3K/AKT pathway genomic alterations (GA)."
Deep research cited this publication as relevant literature for Metastatic Breast Carcinoma.
DOI:10.1007/s10549-024-07469-6
Trends in HR+ metastatic breast cancer survival before and after CDK4/6 inhibitor introduction in the United States: a SEER registry analysis of patients with HER2− and HER2+ metastatic breast cancer
1 finding
Trends in HR+ metastatic breast cancer survival before and after CDK4/6 inhibitor introduction in the United States: a SEER registry analysis of patients with HER2− and HER2+ metastatic breast cancer
"Trends in HR+ metastatic breast cancer survival before and after CDK4/6 inhibitor introduction in the United States: a SEER registry analysis of patients with HER2− and HER2+ metastatic breast cancer"
DOI:10.1016/j.esmoop.2024.104083
Use and outcomes of trastuzumab deruxtecan in HER2-positive and HER2-low metastatic breast cancer in a real-world setting: a nationwide cohort study
1 finding
Use and outcomes of trastuzumab deruxtecan in HER2-positive and HER2-low metastatic breast cancer in a real-world setting: a nationwide cohort study
"Use and outcomes of trastuzumab deruxtecan in HER2-positive and HER2-low metastatic breast cancer in a real-world setting: a nationwide cohort study"
DOI:10.1038/s41591-024-03269-z
Sacituzumab govitecan in HR+HER2− metastatic breast cancer: the randomized phase 3 EVER-132-002 trial
1 finding
Sacituzumab govitecan in HR+HER2− metastatic breast cancer: the randomized phase 3 EVER-132-002 trial
"Sacituzumab govitecan in HR+HER2− metastatic breast cancer: the randomized phase 3 EVER-132-002 trial"
DOI:10.1038/s41598-025-12883-x
Patterns and prognostic implications of distant metastasis in breast Cancer based on SEER population data
1 finding
Distant metastasis remains the leading cause of mortality in breast cancer, yet comprehensive population-based evaluations of metastatic site combinations and their survival implications are limited.
"Distant metastasis remains the leading cause of mortality in breast cancer, yet comprehensive population-based evaluations of metastatic site combinations and their survival implications are limited."
Show evidence (1 reference)
DOI:10.1038/s41598-025-12883-x SUPPORT Human Clinical
"Distant metastasis remains the leading cause of mortality in breast cancer, yet comprehensive population-based evaluations of metastatic site combinations and their survival implications are limited."
Deep research cited this publication as relevant literature for Metastatic Breast Carcinoma.
DOI:10.1056/nejmoa2214131
Capivasertib in Hormone Receptor–Positive Advanced Breast Cancer
1 finding
Capivasertib in Hormone Receptor–Positive Advanced Breast Cancer
"Capivasertib in Hormone Receptor–Positive Advanced Breast Cancer"
DOI:10.1186/s12885-025-14786-6
Epidemiology and outcomes associated with brain metastases among patients with metastatic breast cancer – a cohort study in US electronic health record data
1 finding
Epidemiology and outcomes associated with brain metastases among patients with metastatic breast cancer – a cohort study in US electronic health record data
"There are limited real-world data on the prevalence of brain metastases (BM) in metastatic breast cancer (mBC) across the treatment pathway, especially when stratified by human epidermal growth factor receptor 2–positive (HER2+) or HER2–negative (HER2−) status."
Show evidence (1 reference)
DOI:10.1186/s12885-025-14786-6 SUPPORT Other
"There are limited real-world data on the prevalence of brain metastases (BM) in metastatic breast cancer (mBC) across the treatment pathway, especially when stratified by human epidermal growth factor receptor 2–positive (HER2+) or HER2–negative (HER2−) status."
Deep research cited this publication as relevant literature for Metastatic Breast Carcinoma.
DOI:10.1200/jco.23.02112
US Food and Drug Administration Approval Summary: Elacestrant for Estrogen Receptor–Positive, Human Epidermal Growth Factor Receptor 2–Negative, <i>ESR1</i>-Mutated Advanced or Metastatic Breast Cancer
1 finding
US Food and Drug Administration Approval Summary: Elacestrant for Estrogen Receptor–Positive, Human Epidermal Growth Factor Receptor 2–Negative, <i>ESR1</i>-Mutated Advanced or Metastatic Breast Cancer
"The US Food and Drug Administration (FDA) approved elacestrant for the treatment of postmenopausal women or adult men with estrogen receptor–positive (ER+), human epidermal growth factor receptor 2–negative (HER2–), estrogen receptor 1 ( ESR1)–mutated advanced or metastatic breast cancer with..."
Show evidence (1 reference)
DOI:10.1200/jco.23.02112 SUPPORT Human Clinical
"The US Food and Drug Administration (FDA) approved elacestrant for the treatment of postmenopausal women or adult men with estrogen receptor–positive (ER+), human epidermal growth factor receptor 2–negative (HER2–), estrogen receptor 1 ( ESR1)–mutated advanced or metastatic breast cancer with..."
Deep research cited this publication as relevant literature for Metastatic Breast Carcinoma.
DOI:10.33590/oncolamj/ctrc4560
Updates in Advanced Hormone Receptor-Positive Breast Cancer: From Circulating Tumor DNA-Guided Therapy to Precision Medicine
1 finding
The therapeutic landscape for hormone receptor-positive (HR+) advanced breast cancer (BC) is moving from generalized endocrine therapies to highly targeted, biomarker-driven strategies.
"The therapeutic landscape for hormone receptor-positive (HR+) advanced breast cancer (BC) is moving from generalized endocrine therapies to highly targeted, biomarker-driven strategies."
Show evidence (1 reference)
DOI:10.33590/oncolamj/ctrc4560 SUPPORT Human Clinical
"The therapeutic landscape for hormone receptor-positive (HR+) advanced breast cancer (BC) is moving from generalized endocrine therapies to highly targeted, biomarker-driven strategies."
Deep research cited this publication as relevant literature for Metastatic Breast Carcinoma.
DOI:10.3389/fendo.2023.1184895
Patterns of de novo metastasis and survival outcomes by age in breast cancer patients: a SEER population-based study
1 finding
The role of age in metastatic disease, including breast cancer, remains obscure.
"The role of age in metastatic disease, including breast cancer, remains obscure."
Show evidence (1 reference)
DOI:10.3389/fendo.2023.1184895 SUPPORT Human Clinical
"The role of age in metastatic disease, including breast cancer, remains obscure."
Deep research cited this publication as relevant literature for Metastatic Breast Carcinoma.
DOI:10.3390/cancers17213505
Trastuzumab–Deruxtecan for the Treatment of Metastatic Breast Cancer Patients: Data from Real World Studies
1 finding
Trastuzumab–Deruxtecan for the Treatment of Metastatic Breast Cancer Patients: Data from Real World Studies
"Trastuzumab–deruxtecan (T-DXd), a new-generation antibody drug conjugate, has greatly improved the survival and clinical benefit rates of patients affected by advanced HER2-positive/HER2-low breast cancer according to the results of controlled clinical trials with a manageable safety profile."
Show evidence (1 reference)
DOI:10.3390/cancers17213505 SUPPORT Human Clinical
"Trastuzumab–deruxtecan (T-DXd), a new-generation antibody drug conjugate, has greatly improved the survival and clinical benefit rates of patients affected by advanced HER2-positive/HER2-low breast cancer according to the results of controlled clinical trials with a manageable safety profile."
Deep research cited this publication as relevant literature for Metastatic Breast Carcinoma.
DOI:10.3390/curroncol32010001
The Real-World Clinical Outcomes of Heavily Pretreated HER2+ and HER2-Low Metastatic Breast Cancer Patients Treated with Trastuzumab Deruxtecan at a Single Centre
1 finding
Trastuzumab deruxtecan (TDXd) is an antibody–drug conjugate that has demonstrated impressive activity in randomized controlled clinical trials in the context of patients with HER2-amplified and HER2-low metastatic breast cancer.
"Trastuzumab deruxtecan (TDXd) is an antibody–drug conjugate that has demonstrated impressive activity in randomized controlled clinical trials in the context of patients with HER2-amplified and HER2-low metastatic breast cancer."
Show evidence (1 reference)
DOI:10.3390/curroncol32010001 SUPPORT Human Clinical
"Trastuzumab deruxtecan (TDXd) is an antibody–drug conjugate that has demonstrated impressive activity in randomized controlled clinical trials in the context of patients with HER2-amplified and HER2-low metastatic breast cancer."
Deep research cited this publication as relevant literature for Metastatic Breast Carcinoma.