Metastatic Breast Carcinoma (Metastatic Breast Cancer): Disease Characteristics Research Report

Scope and evidence note: This report is limited to sources successfully retrieved in the tool run. Several requested ontology identifiers (e.g., specific MONDO term for metastatic breast carcinoma, ICD-10/ICD-11 codes, MeSH tree numbers) were not directly retrievable from the available corpus; where absent, this is stated explicitly.

Target disease

• Disease name: Metastatic breast carcinoma (metastatic breast cancer; stage IV breast cancer)
• Category: Malignant neoplasm (carcinoma) with distant metastasis
• MONDO ID: Not confirmed for the specific entity “metastatic breast carcinoma” in the retrieved sources. (The OpenTargets query returned MONDO_0007254 for “breast cancer” rather than a metastatic-specific MONDO term.) (OpenTargets Search: metastatic breast carcinoma)

1. Disease information

1.1 Definition and current understanding

Metastatic breast carcinoma refers to breast carcinoma that has spread beyond the breast and regional lymph nodes to distant organs (distant metastasis). It is clinically aligned with stage IV breast cancer, including both de novo metastatic disease (metastatic at first diagnosis) and recurrent metastatic disease (metastasis after earlier-stage treatment). Population-based analyses use SEER “distant metastasis” indicators and commonly track organ sites including bone, lung, liver, and brain (zhang2025patternsandprognostic pages 1-2, zhang2025patternsandprognostic pages 2-4).

1.2 Synonyms / alternative names

Commonly used synonyms in the retrieved literature include: - metastatic breast cancer (mBC) - de novo metastatic breast cancer - stage IV breast cancer - advanced breast cancer (often includes locally advanced + metastatic; context dependent) (OpenTargets Search: metastatic breast carcinoma, varghese2025epidemiologyandoutcomes pages 1-2)

1.3 Key identifiers

• MONDO: not confirmed for metastatic-specific entity from retrieved sources (see Scope note).
• MeSH/ICD-10/ICD-11/OMIM/Orphanet: not retrieved in this run.

1.4 Evidence source types represented

• Aggregated registry data: SEER population studies of de novo metastatic disease and metastatic patterns (OpenTargets Search: metastatic breast carcinoma, zhang2025patternsandprognostic pages 8-10, zhang2025patternsandprognostic pages 1-2).
• Aggregated EHR real-world data: Flatiron Health EHR cohort for brain metastases outcomes (varghese2025epidemiologyandoutcomes pages 1-2).
• Randomized controlled trials (RCTs): CAPItello-291, EVER-132-002; summarized directly from primary publications/figures (turner2023capivasertibinhormone media c3df1a43, turner2023capivasertibinhormone media 7aa4aaf1, evangelou2025updatesinadvanced pages 3-4).
• Regulatory science: FDA approval summary for elacestrant (shah2024usfoodand pages 1-2).
• Real-world observational cohorts: nationwide French cohort and single-center series for trastuzumab deruxtecan (T-DXd) (jourdain2024useandoutcomes pages 1-2, lazaratos2024therealworldclinical pages 1-2).

2. Etiology

Metastatic breast carcinoma represents progression of breast carcinoma via biological programs enabling invasion, dissemination, and colonization of distant sites. In the retrieved corpus, etiology is most directly addressed through genomic correlates of endocrine resistance and treatment-driven selection.

2.1 Disease causal factors (mechanistic/biologic)

A central mechanistic theme in HR+/HER2− metastatic disease is endocrine therapy resistance associated with acquired ESR1 mutations (shah2024usfoodand pages 1-2, bhave2024comprehensivegenomicprofiling pages 1-2).

2.2 Risk factors for metastasis / progression (from retrieved evidence)

• Age and survival gradient in de novo metastatic disease: In a SEER analysis of de novo metastatic breast cancer (2010–2019), 5-year OS declined with age: ≤40 years 42.1%, 41–60 years 34.8%, 61–80 years 28.3%, >80 years 11.8% (OpenTargets Search: metastatic breast carcinoma).
• Metastatic burden and site pattern: In SEER-based metastatic patterning, multi-organ metastasis—particularly combinations including brain—was associated with the worst survival (e.g., liver+lung+brain median OS 4.0 months) (zhang2025patternsandprognostic pages 1-2, zhang2025patternsandprognostic pages 6-8).

2.3 Protective factors

Not directly retrievable from the available sources.

2.4 Gene–environment interactions

Not directly retrievable from the available sources.

3. Phenotypes

3.1 Common metastatic sites and frequencies

SEER-based patterning (2014–2023) reports that among metastatic cases, bone was most common (21.3%), followed by lung (16.1%), liver (9.2%), and brain (2.9%) (zhang2025patternsandprognostic pages 1-2). In the same dataset, specific metastatic patterns had reported median OS values, e.g., bone-only 16.0 months, lung-only 14.0, liver-only 12.0, brain-only 5.0 (zhang2025patternsandprognostic pages 6-8).

Brain metastases are a clinically important complication: an EHR-derived cohort study emphasizes prevalence and survival penalties associated with brain metastases, including lower median OS among patients with brain metastases versus those without (varghese2025epidemiologyandoutcomes pages 1-2).

3.2 Phenotype characteristics (onset, progression, frequency)

• Onset: Metastatic disease may be present at diagnosis (de novo stage IV) or emerge after earlier-stage treatment; the SEER de novo metastatic cohort comprised 24,155 patients (4.4% of all patients) diagnosed 2010–2019 (OpenTargets Search: metastatic breast carcinoma).
• Progression/organotropism by subtype: Molecular subtypes show distinct organotropism; HR+/HER2− tumors are more prone to bone-only metastasis, whereas HER2-positive and triple-negative subtypes are more likely to involve visceral and brain metastases (zhang2025patternsandprognostic pages 1-2).

3.3 Quality-of-life impact

Direct patient-reported outcome instruments (e.g., EQ-5D, SF-36) were not retrievable in the available sources. However, brain metastases are noted to be associated with worse outcomes and limited uptake of guideline-recommended systemic therapies in practice, suggesting substantial morbidity and care gaps (varghese2025epidemiologyandoutcomes pages 1-2).

3.4 Suggested HPO terms (examples)

Because HPO mappings were not present explicitly in retrieved sources, the following are suggested mappings consistent with metastatic patterns and clinical manifestations: - Metastatic lesion / distant metastasis: Metastatic neoplasm (HP:0003002; candidate) - Bone metastasis-related: bone pain (HP:0002653; candidate), pathological fracture (HP:0002756; candidate) - Lung metastasis-related: dyspnea (HP:0002094; candidate) - Liver metastasis-related: hepatomegaly (HP:0002240; candidate), abnormal liver function tests (HP:0002910; candidate) - Brain metastasis-related: headache (HP:0002315; candidate), seizures (HP:0001250; candidate), focal neurologic deficits (broad)

(These are ontology suggestions; frequencies for each symptom were not available in the retrieved literature.)

4. Genetic / molecular information

4.1 Actionable and recurrent alterations highlighted in retrieved evidence

ESR1 (endocrine resistance)

• FDA approval summary describes elacestrant for ER+/HER2−, ESR1-mutated advanced/metastatic breast cancer after progression on endocrine therapy (shah2024usfoodand pages 1-2).
• The FDA summary states EMERALD included 228 ESR1-mutated patients and demonstrated PFS benefit in ESR1-mutant subgroup (HR 0.55) (shah2024usfoodand pages 1-2).

PI3K/AKT/PTEN axis (endocrine resistance and targeted therapy)

• CAPItello-291 evaluates AKT inhibition (capivasertib) added to fulvestrant, motivated by the concept that “AKT pathway activation is implicated in endocrine-therapy resistance” (abstract background) (turner2023capivasertibinhormone media c3df1a43).
• In a real-world comprehensive genomic profiling study, ~60% of HR+/HER2− metastatic cases in 1st line harbored ≥1 alteration among ESR1/PIK3CA/AKT1/PTEN when measured by tissue biopsy or liquid biopsy with sufficient ctDNA tumor fraction (bhave2024comprehensivegenomicprofiling pages 1-2).

4.2 Prevalence across treatment lines (real-world)

In HR+/HER2− metastatic breast cancer: - ESR1 mutations in 1st line: 8.1% (tissue biopsy), 17.5% (liquid biopsy, ctDNA tumor fraction ≥1%), 4.9% (liquid biopsy, tumor fraction <1%), rising to 59% in 3rd line (liquid biopsy, tumor fraction ≥1%) (bhave2024comprehensivegenomicprofiling pages 1-2).

4.3 Somatic vs germline

The retrieved evidence emphasizes somatic acquired ESR1 mutations (endocrine resistance) (shah2024usfoodand pages 1-2, bhave2024comprehensivegenomicprofiling pages 1-2). Germline predisposition genes (e.g., BRCA1/2, PALB2) were not characterized in detail within the evidence snippets obtained here.

4.4 Epigenetics and chromosomal abnormalities

Not directly retrievable from the available sources.

5. Environmental information

Not directly retrievable from the available sources.

6. Mechanism / pathophysiology

6.1 Causal chains emphasized in retrieved evidence

1. Endocrine therapy pressure (HR+ disease) → selection/emergence of ESR1 mutations → endocrine resistance → disease progression requiring therapy switch (shah2024usfoodand pages 1-2, bhave2024comprehensivegenomicprofiling pages 1-2).
2. PI3K/AKT/PTEN pathway activation contributes to endocrine resistance → AKT inhibition (capivasertib) can restore/improve control when combined with fulvestrant (turner2023capivasertibinhormone media c3df1a43, turner2023capivasertibinhormone media 7aa4aaf1).
3. Brain metastasis development in metastatic course → worsened OS and a care gap where many patients do not receive guideline-recommended systemic regimens (varghese2025epidemiologyandoutcomes pages 1-2).

6.2 Pathway and ontology term suggestions

• PI3K/AKT signaling: GO:0014065 (phosphatidylinositol 3-kinase signaling; candidate)
• AKT signaling: GO:0043491 (protein kinase B signaling; candidate)
• Estrogen receptor signaling: GO:0030520 (intracellular estrogen receptor signaling pathway; candidate)
• Metastatic dissemination: GO:0001837 (epithelial to mesenchymal transition; candidate), GO:0016477 (cell migration; candidate)

6.3 Cell types (Cell Ontology; examples)

• Breast epithelial cell / mammary gland epithelial cell (CL term candidates)
• Circulating tumor cell (CL:0001063; candidate)
• Tumor-associated macrophage (broad immune cell involvement; candidate)

(Specific single-cell/spatial transcriptomic findings were not retrievable in this run.)

7. Anatomical structures affected

7.1 Organ-level targets (from metastatic patterns)

Common distant sites include: - Bone (most common) (zhang2025patternsandprognostic pages 1-2) - Lung (zhang2025patternsandprognostic pages 1-2) - Liver (zhang2025patternsandprognostic pages 1-2) - Brain (less frequent, but high impact) (zhang2025patternsandprognostic pages 1-2, varghese2025epidemiologyandoutcomes pages 1-2)

7.2 UBERON term suggestions (examples)

• Bone tissue (UBERON:0002481; candidate)
• Lung (UBERON:0002048; candidate)
• Liver (UBERON:0002107; candidate)
• Brain (UBERON:0000955; candidate)

8. Temporal development

8.1 Onset patterns

• De novo metastatic breast cancer represented 4.4% of cases in one SEER de novo metastasis cohort (2010–2019) (OpenTargets Search: metastatic breast carcinoma).

8.2 Progression and metastatic burden

In the SEER metastatic-pattern analysis, increasing metastatic burden correlated with worse median OS, e.g., single-site median OS 15.0 months, double-site 12.0 months, and specific multi-organ combinations including brain reaching median OS 4.0 months (zhang2025patternsandprognostic pages 6-8).

9. Inheritance and population

9.1 Epidemiology and outcomes (registry/EHR)

• Metastatic site distribution (metastatic cases): bone 21.3%, lung 16.1%, liver 9.2%, brain 2.9% (SEER 2014–2023 analysis) (zhang2025patternsandprognostic pages 1-2).
• Age-stratified survival in de novo metastatic breast cancer: 5-year OS 42.1% (≤40), 34.8% (41–60), 28.3% (61–80), 11.8% (>80) (OpenTargets Search: metastatic breast carcinoma).
• Brain metastases in EHR cohort: prevalence at metastatic diagnosis 12.5% (HER2+) vs 1.7% (HER2−); median OS from metastatic diagnosis 24 vs 37 months (HER2+) and 12 vs 27 months (HER2−) for patients with vs without brain metastases (varghese2025epidemiologyandoutcomes pages 1-2).

9.2 Inheritance

Hereditary breast cancer genetics (inheritance patterns, penetrance, founder effects) were not directly retrievable in this run.

10. Diagnostics

10.1 Biomarker testing and clinical utility (evidence retrieved)

ESR1 mutation testing (tissue and liquid biopsy)

• The FDA approval summary notes elacestrant approval is restricted to ESR1-mutated ER+/HER2− advanced/metastatic disease; it describes EMERALD as the basis and highlights that post-aromatase inhibitor treatment, ~20–40% of patients may develop ESR1 mutations (shah2024usfoodand pages 1-2).
• Real-world genomic profiling supports a testing strategy: tissue biopsy CGP at de novo/recurrent diagnosis, followed by liquid biopsy in later lines to detect acquired alterations; reflex tissue testing should be considered when ctDNA tumor fraction is low (bhave2024comprehensivegenomicprofiling pages 1-2).

HER2-low definition (diagnostic concept)

A T-DXd synthesis reports HER2-low definition consistent with modern practice: IHC 1+ or IHC 2+ with negative ISH (quaquarini2025trastuzumab–deruxtecanforthe pages 3-4).

10.2 Imaging / biopsy

Specific imaging performance metrics were not retrievable in this run; however, registry/EHR studies operationalize metastatic site assignment using structured metastasis variables (SEER) and EHR documentation by line-of-therapy (varghese2025epidemiologyandoutcomes pages 1-2, zhang2025patternsandprognostic pages 1-2).

11. Outcome / prognosis

11.1 Survival by metastatic pattern (SEER)

In a SEER-based metastatic pattern study, median OS differed by site and combinations: - Bone-only 16.0 months; lung-only 14.0; liver-only 12.0; brain-only 5.0 (zhang2025patternsandprognostic pages 6-8). - Liver+lung+brain had the shortest median OS 4.0 months (zhang2025patternsandprognostic pages 1-2, zhang2025patternsandprognostic pages 6-8).

11.2 Population survival improvement post-CDK4/6 inhibitor era (SEER)

A SEER registry analysis comparing pre-2015 vs post-2015 guideline era in HR+/HER2− de novo metastatic breast cancer found an adjusted ~10% reduction in risk of breast cancer-specific death post-2015 (HR 0.895; p<0.0001) (OpenTargets Search: metastatic breast carcinoma).

12. Treatment

12.1 Key recent developments (2023–2024 priority) and trial results

A summary table is provided for rapid reference.

Table: This table summarizes pivotal 2023–2024 trials and selected registry/real-world studies relevant to metastatic breast carcinoma, emphasizing efficacy, survival, and safety outcomes. It is useful for quickly comparing biomarker-defined treatment evidence with real-world epidemiology and outcome data.

12.1.1 Targeting PI3K/AKT/PTEN axis: Capivasertib + fulvestrant (CAPItello-291)

CAPItello-291 (NCT04305496) showed statistically significant PFS improvements: - Overall: median PFS 7.2 vs 3.6 months; HR 0.60 (95% CI 0.51–0.71); P<0.001 (turner2023capivasertibinhormone media c3df1a43). - AKT pathway–altered: median PFS 7.3 vs 3.1 months; HR 0.50 (95% CI 0.38–0.65); P<0.001 (turner2023capivasertibinhormone media 7aa4aaf1). Notable grade ≥3 AEs included rash and diarrhea; discontinuations were higher in the capivasertib arm (turner2023capivasertibinhormone media c3df1a43).

12.1.2 Antibody–drug conjugate for HR+/HER2− metastatic disease: Sacituzumab govitecan (EVER-132-002)

EVER-132-002 (NCT04639986) reported: - PFS HR 0.67 with median 4.3 vs 4.2 months (P=0.0028) - OS HR 0.64 with median 21.0 vs 15.3 months (P=0.0061) with common grade ≥3 hematologic toxicities (evangelou2025updatesinadvanced pages 3-4).

12.1.3 ESR1-mutated ER+/HER2−: Elacestrant (FDA approval summary of EMERALD)

From the FDA approval summary: - ESR1-mutant subgroup PFS benefit: HR 0.55 (95% CI 0.39–0.77); P=.0005 - OS endpoint not met; no OS detriment signal: HR 0.90 (95% CI 0.63–1.30) - More nausea, vomiting, dyslipidemia with elacestrant (shah2024usfoodand pages 1-2).

12.1.4 HER2-positive and HER2-low metastatic disease: Trastuzumab deruxtecan (T-DXd) real-world implementation

• French nationwide cohort (ESMO Open 2024): median OS 30.2 months in HER2+ third-line and 16.8 months in HER2-low second-line; brain metastases were common (e.g., 16% in HER2-low second-line cohort). The cohort highlights routine-care populations being older/more comorbid than trials and underscores severe ILD/pneumonitis risk requiring surveillance (jourdain2024useandoutcomes pages 1-2).
• Single-center series (Current Oncology 2024): among 33 evaluable patients, ORR 63% with 10.5% pneumonitis (including grade 3 cases), no grade 4–5 toxicities (lazaratos2024therealworldclinical pages 1-2).

12.2 MAXO term suggestions (examples)

• Endocrine therapy (MAXO: endocrine therapy; candidate)
• Cyclin-dependent kinase inhibitor therapy (MAXO: CDK inhibitor therapy; candidate)
• AKT inhibitor therapy (MAXO: targeted molecular therapy; candidate)
• Antibody–drug conjugate therapy (MAXO: antibody therapy + chemotherapy conjugate; candidate)
• Liquid biopsy testing / ctDNA testing (MAXO: diagnostic procedure; candidate)

(Exact MAXO identifiers were not retrievable in this run; these are semantic suggestions.)

13. Prevention

Not directly retrievable from the available sources.

14. Other species / natural disease

Not directly retrievable from the available sources.

15. Model organisms

Not directly retrievable from the available sources.

Direct abstract quotations supporting key claims (selected)

• CAPItello-291 mechanistic rationale: “AKT pathway activation is implicated in endocrine-therapy resistance.” (turner2023capivasertibinhormone media c3df1a43)
• EMERALD/elacestrant regulatory conclusion: “The approval of elacestrant in ER+, HER2– advanced or metastatic breast cancer was restricted to patients with ESR1 mutations.” (shah2024usfoodand pages 1-2)
• EVER-132-002 conclusion: “SG demonstrated significant and clinically meaningful improvement in PFS and OS versus chemotherapy, with a manageable safety profile …” (evangelou2025updatesinadvanced pages 3-4)

Key real-world/practice gaps highlighted

In a large EHR cohort, “most [patients with brain metastases] were not receiving NCCN Guideline®-recommended systemic therapies,” with poorer OS in those with brain metastases (varghese2025epidemiologyandoutcomes pages 1-2).

References (URLs and publication dates)

URLs and dates are provided inline in each cited publication row and in the trial table artifact. Key examples include: - Turner et al., N Engl J Med, Jun 2023, CAPItello-291. https://doi.org/10.1056/NEJMoa2214131 (turner2023capivasertibinhormone media c3df1a43, turner2023capivasertibinhormone media 7aa4aaf1) - Xu et al., Nature Medicine, Oct 2024, EVER-132-002. https://doi.org/10.1038/s41591-024-03269-z (evangelou2025updatesinadvanced pages 3-4) - Shah et al., J Clin Oncol, Apr 2024, FDA summary for elacestrant. https://doi.org/10.1200/jco.23.02112 (shah2024usfoodand pages 1-2) - Jourdain et al., ESMO Open, Dec 2024, French nationwide T-DXd cohort. https://doi.org/10.1016/j.esmoop.2024.104083 (jourdain2024useandoutcomes pages 1-2) - Lazaratos et al., Current Oncology, Dec 2024, single-center T-DXd series. https://doi.org/10.3390/curroncol32010001 (lazaratos2024therealworldclinical pages 1-2)

Items not available in retrieved evidence (explicitly)

• Metastatic-breast-carcinoma-specific MONDO ID; ICD-10/ICD-11 codes; MeSH ID; OMIM/Orphanet IDs.
• Detailed environmental/lifestyle risk factors, protective factors.
• Systematic coverage of germline predisposition variants and allele frequencies (ClinVar/gnomAD), epigenetic mechanisms, and animal models.
• Formal diagnostic test performance statistics for imaging modalities.

References

1. (OpenTargets Search: metastatic breast carcinoma): Open Targets Query (metastatic breast carcinoma, 50 results). Buniello, A. et al. (2025). Open Targets Platform: facilitating therapeutic hypotheses building in drug discovery. Nucleic Acids Research.

2. (zhang2025patternsandprognostic pages 1-2): Maoquan zhang, Hanqing Deng, Rihua Hu, Fuwei Chen, Shiwen Dong, Shiyi Zhang, Wenyan Guo, Wen Yang, and Wenxin Chen. Patterns and prognostic implications of distant metastasis in breast cancer based on seer population data. Scientific Reports, Jul 2025. URL: https://doi.org/10.1038/s41598-025-12883-x, doi:10.1038/s41598-025-12883-x. This article has 34 citations and is from a peer-reviewed journal.

3. (zhang2025patternsandprognostic pages 2-4): Maoquan zhang, Hanqing Deng, Rihua Hu, Fuwei Chen, Shiwen Dong, Shiyi Zhang, Wenyan Guo, Wen Yang, and Wenxin Chen. Patterns and prognostic implications of distant metastasis in breast cancer based on seer population data. Scientific Reports, Jul 2025. URL: https://doi.org/10.1038/s41598-025-12883-x, doi:10.1038/s41598-025-12883-x. This article has 34 citations and is from a peer-reviewed journal.

4. (varghese2025epidemiologyandoutcomes pages 1-2): Della Varghese, Jenna Collins, Beth Nordstrom, Miguel Miranda, Brian Murphy, and David Harland. Epidemiology and outcomes associated with brain metastases among patients with metastatic breast cancer – a cohort study in us electronic health record data. BMC Cancer, Oct 2025. URL: https://doi.org/10.1186/s12885-025-14786-6, doi:10.1186/s12885-025-14786-6. This article has 1 citations and is from a peer-reviewed journal.

5. (zhang2025patternsandprognostic pages 8-10): Maoquan zhang, Hanqing Deng, Rihua Hu, Fuwei Chen, Shiwen Dong, Shiyi Zhang, Wenyan Guo, Wen Yang, and Wenxin Chen. Patterns and prognostic implications of distant metastasis in breast cancer based on seer population data. Scientific Reports, Jul 2025. URL: https://doi.org/10.1038/s41598-025-12883-x, doi:10.1038/s41598-025-12883-x. This article has 34 citations and is from a peer-reviewed journal.

6. (turner2023capivasertibinhormone media c3df1a43): Nicholas C. Turner, Mafalda Oliveira, Sacha J. Howell, Florence Dalenc, Javier Cortes, Henry L. Gomez Moreno, Xichun Hu, Komal Jhaveri, Petr Krivorotko, Sibylle Loibl, Serafin Morales Murillo, Meena Okera, Yeon Hee Park, Joohyuk Sohn, Masakazu Toi, Eriko Tokunaga, Samih Yousef, Lyudmila Zhukova, Elza C. de Bruin, Lynda Grinsted, Gaia Schiavon, Andrew Foxley, and Hope S. Rugo. Capivasertib in hormone receptor-positive advanced breast cancer. The New England journal of medicine, 388 22:2058-2070, Jun 2023. URL: https://doi.org/10.1056/nejmoa2214131, doi:10.1056/nejmoa2214131. This article has 832 citations and is from a highest quality peer-reviewed journal.

7. (turner2023capivasertibinhormone media 7aa4aaf1): Nicholas C. Turner, Mafalda Oliveira, Sacha J. Howell, Florence Dalenc, Javier Cortes, Henry L. Gomez Moreno, Xichun Hu, Komal Jhaveri, Petr Krivorotko, Sibylle Loibl, Serafin Morales Murillo, Meena Okera, Yeon Hee Park, Joohyuk Sohn, Masakazu Toi, Eriko Tokunaga, Samih Yousef, Lyudmila Zhukova, Elza C. de Bruin, Lynda Grinsted, Gaia Schiavon, Andrew Foxley, and Hope S. Rugo. Capivasertib in hormone receptor-positive advanced breast cancer. The New England journal of medicine, 388 22:2058-2070, Jun 2023. URL: https://doi.org/10.1056/nejmoa2214131, doi:10.1056/nejmoa2214131. This article has 832 citations and is from a highest quality peer-reviewed journal.

8. (evangelou2025updatesinadvanced pages 3-4): Christos Evangelou. Updates in advanced hormone receptor-positive breast cancer: from circulating tumor dna-guided therapy to precision medicine. American Medical Journal Oncology, pages 40-49, Jul 2025. URL: https://doi.org/10.33590/oncolamj/ctrc4560, doi:10.33590/oncolamj/ctrc4560. This article has 1 citations.

9. (shah2024usfoodand pages 1-2): Mirat Shah, Hima Lingam, Xin Gao, Haley Gittleman, Mallorie H. Fiero, Danielle Krol, Nikolett Biel, Tiffany K. Ricks, Wentao Fu, Salaheldin Hamed, Fang Li, Jillian (Jielin) Sun, Jianghong Fan, Robert Schuck, Manuela Grimstein, Liuya Tang, Shyam Kalavar, Abdelrahmman Abukhdeir, Anand Pathak, Soma Ghosh, Ilynn Bulatao, Amy Tilley, William F. Pierce, Bronwyn D. Mixter, Shenghui Tang, Richard Pazdur, Paul Kluetz, and Laleh Amiri-Kordestani. Us food and drug administration approval summary: elacestrant for estrogen receptor–positive, human epidermal growth factor receptor 2–negative, esr1-mutated advanced or metastatic breast cancer. Journal of Clinical Oncology, 42:1193-1201, Apr 2024. URL: https://doi.org/10.1200/jco.23.02112, doi:10.1200/jco.23.02112. This article has 39 citations and is from a highest quality peer-reviewed journal.

10. (jourdain2024useandoutcomes pages 1-2): H. Jourdain, A. Di Meglio, I. Mansouri, D. Desplas, M. Zureik, and N. Haddy. Use and outcomes of trastuzumab deruxtecan in her2-positive and her2-low metastatic breast cancer in a real-world setting: a nationwide cohort study. ESMO Open, 9:104083, Dec 2024. URL: https://doi.org/10.1016/j.esmoop.2024.104083, doi:10.1016/j.esmoop.2024.104083. This article has 15 citations and is from a domain leading peer-reviewed journal.

11. (lazaratos2024therealworldclinical pages 1-2): Anna-Maria Lazaratos, Matthew Dankner, Aalya Hamouda, Soumaya Labidi, Victor Cohen, Lawrence Panasci, Jennifer E. Friedmann, François Patenaude, Cristiano Ferrario, Mark Basik, April A. N. Rose, and Parvaneh Fallah. The real-world clinical outcomes of heavily pretreated her2+ and her2-low metastatic breast cancer patients treated with trastuzumab deruxtecan at a single centre. Current Oncology, 32:1, Dec 2024. URL: https://doi.org/10.3390/curroncol32010001, doi:10.3390/curroncol32010001. This article has 9 citations.

12. (bhave2024comprehensivegenomicprofiling pages 1-2): Manali A. Bhave, Julia C. F. Quintanilha, Hanna Tukachinsky, Gerald Li, Takara Scott, Jeffrey S. Ross, Lincoln Pasquina, Richard S. P. Huang, Heather McArthur, Mia A. Levy, Ryon P. Graf, and Kevin Kalinsky. 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. Breast Cancer Research and Treatment, 207:599-609, Jun 2024. URL: https://doi.org/10.1007/s10549-024-07376-w, doi:10.1007/s10549-024-07376-w. This article has 50 citations and is from a peer-reviewed journal.

13. (zhang2025patternsandprognostic pages 6-8): Maoquan zhang, Hanqing Deng, Rihua Hu, Fuwei Chen, Shiwen Dong, Shiyi Zhang, Wenyan Guo, Wen Yang, and Wenxin Chen. Patterns and prognostic implications of distant metastasis in breast cancer based on seer population data. Scientific Reports, Jul 2025. URL: https://doi.org/10.1038/s41598-025-12883-x, doi:10.1038/s41598-025-12883-x. This article has 34 citations and is from a peer-reviewed journal.

14. (quaquarini2025trastuzumab–deruxtecanforthe pages 3-4): Erica Quaquarini, Federica Luelli, Angioletta Lasagna, Gianpiero Rizzo, Lorenzo Perrone, Simone Figini, Raffaella Achille, and Paolo Pedrazzoli. Trastuzumab–deruxtecan for the treatment of metastatic breast cancer patients: data from real world studies. Cancers, 17:3505, Oct 2025. URL: https://doi.org/10.3390/cancers17213505, doi:10.3390/cancers17213505. This article has 4 citations.