Citations 2
Characteristics of Gender-Diverse Patients With Breast Cancer
Cortina, Chandler S., Brazauskas, Ruta , Flanagan, Meghan R., Dill, Ellen D., Joseph, Kathe-Ann P., Trifonov, Alexandr , Kim, Esther A. , Kantor, Olga, Barmettler, Gabi , Rosenberger, Laura H., Jordan, Sumanas W., Perez, Megan M. , Jimenez, Rachel B., Smart, Alicia , Walker, J C, Lautner, Meeghan A., Siegel, Emily L., Brabender, Danielle , Al-Hilli, Zahraa, Cassidy, Michael R., Weiss, Anna, McCaffrey, Rachel L., Lee, M Catherine, Kaoutzanis, Christodoulos, Nguyen, Khoa N., Son, Jennifer D., Williams, Austin D., Madrigrano, Andrea, McLaughlin, Sarah A., Stolley, Melinda, Cortina, Chandler S. , Flanagan, Meghan R. , Mukhtar, Rita A. , Kantor, Olga , Rezak, Kristen M. , Rosenberger, Laura H. , Jimenez, Rachel , Kopkash, Katherine A. , Hughes, Tasha M. , Walker, Jasmine C. , Lautner, Meeghan Ann, Siegel, Emily , Al‐Hilli, Zahraa , Cassidy, Michael Ryan , Weiss, Anna, McCaffrey, Rachel Louise , Kaoutzanis, Christodoulos , Son, Jennifer D. , Williams, Austin David , Petroll, Andrew E. , Stolley, Melinda R.
JAMA Network Open | July 23, 2026 | Volume: 9 | Issue: 7 | Pages: e2624824
10.1001/jamanetworkopen.2026.24824
Importance Limited granular data exist on breast cancer in transgender, nonbinary, and/or gender-diverse (TGD) individuals. Objective To describe patient demographic and tumor clinicopathological variables, clinically relevant risk factors, method of breast cancer detection, treatment characteristics, and locoregional outcomes and to estimate a 5-year breast cancer–specific survival (BCSS). Design, Setting, and Participants This cohort study obtained data on patients treated from 1990 to 2023 from 22 US academic medical centers using institutional databases, electronic medical records, and tumor registries. Included participants were TGD individuals 18 years or older with stage 0 to IV breast cancer. A comparative breast cancer cohort was selected from the 2016 to 2021 Surveillance, Epidemiology, and End Results Program (SEER) breast cancer dataset. Data were analyzed from January to October 2025. Exposure Breast cancer. Main Outcomes and Measures Estimated 5-year BCSS and locoregional recurrence rates. Wilcoxon rank sum and χ 2 tests were used to compare continuous and categorical variables. Kaplan-Meier analysis was used to estimate 5-year BCSS. Results A total of 112 TGD persons (median [IQR] age at diagnosis, 42.5 [36.5-51.0] years; 104 individuals [92.9%] were assigned female at birth) with breast cancer and 1 with bilateral disease were included in the analysis. Forty-three patients (38.4%) used gender-affirming hormone therapy before diagnosis. Among the entire cohort, 58 patients (51.8%) detected their own breast cancer, 68 (60.7%) had a familial breast cancer history, and 16 (14.3%) had a pathogenic germline variant. Tumors were predominantly hormone receptor positive (96 [85.7%]) and early stage (29 [25.7%] ductal carcinoma in situ [DCIS]; 51 [45.1%] stage I). The TGD cohort, compared with patients with breast cancer in the SEER dataset (N = 480 915), was younger (median [IQR] age, 42.5 [36.5-51.0] years vs 62.0 [52.0-72.0] years), had a higher proportion of persons assigned male at birth (8 [7.1%] vs 3522 [0.7%]), more often had progesterone receptor–positive disease (89 [79.5%] vs 335 491 [69.8%]), and presented with earlier-stage disease (eg, DCIS: 29 [25.9%] vs 79 604 [16.6%]). With a median (IQR) follow-up time for the TGD cohort of 38 (24-74) months, 5-year BCSS was favorable at 96.2% (95% CI, 85.3%-99.0%). Conclusions and Relevance This cohort study of TGD patients with breast cancer found that this population was young and often detected their own tumors via self-examination, suggesting opportunities to improve early detection through screening for individuals at elevated risk. Although short-term BCSS appeared favorable, prospective research is essential to define evidence-based guidelines and elucidate long-term outcomes.
Nodal Burden and Oncologic Outcomes in Patients With Residual Isolated Tumor Cells After Neoadjuvant Chemotherapy (ypN0i+): The OPBC-05/ICARO Study
Montagna, Giacomo , Laws, Alison , Ferrucci, Massimo , Mrdutt, Mary M., Sun, Susie X. , Bademler, Süleyman , Balbaloĝlu, Hakan , Balint‐Lahat, Nora, Banys-Paluchowski, Maggie, Barrio, Andrea V. , Benson, John R. , Beşe, Nuran , Boyle, Marissa K. , Diego, Emilia J. , Eden, Claire , Eller, Ruth S. , Goldschmidt, Maite, Hlavin, Callie , Heidinger, Martin , Jelinska, Justyna, Çakmak, Güldeniz Karadeniz , King, Tari A. , Kuerer, Henry M. , Loesch, Julie M, Milardi, Francesco , Murawa, Dawid , Moo, Tracy‐Ann , Menes, Tehillah S. , Passeri, Daniele , Pastoriza, Jessica , Perhavec, Andraž , Pislar, Nina , Polidorio, Natália , Rami, Avina , Ryu, Jai Min , Schulz, Alexandra , Sevilimedu, Varadan , Uğurlu, Mustafa Ümit , Uras, Cihan, Hemert, Annemiek K. E. van , Wong, Stephanie M. , Yoo, Tae-Kyung , Zhang, Jennifer Q. , Cabıoğlu, Neslihan , Peeters, Marie-Jeanne T. F. D. Vrancken , Morrow, Monica , Weber, William P. , Group, on behalf of the ICARO Study, Andreozzi, Mariacarla, Barbalho, Daniel Meirelles , Boileau, J.-F., Brogi, Edi , Cabero, Flávia Vidal, Cocco, Daniela , Bree, Eelco de , Vernet-Tomás, M. , Deutschmann, Christine , Ditsch, Nina, Fick, Franziska, Fitzal, Florian , Flanagan, Meghan R. , Gentile, Damiano , Grabenstetter, Anne , Heil, Jörg, Holtschmidt, Johannes , Krawczyk, Natalia , Kühn, Thorsten, Kümmel, Sherko, Muslumanoglu, Mahmut , Nekljudova, Valentina , Newman, Lisa A. , Poulakaki, Fiorita , Schwartz, Christopher J. , Siegel, Emily , Simonson, Colin , Tampaki, Ekaterini Christina , Tampakis, Athanasios , Tausch, Christoph, Bruele, Astrid Botty van den , Vorburger, Denise , Weiss, Anna, Wimmer, Kerstin , Woodward, Steven G. , Ziauddin, Firdos M., Boughey, JC , Boyle, Marissa K , Eller, Ruth , Heidinger, Martin , Karadeniz Cakmak, Güldeniz , Kesmodel, Susan B , King, Tari A , Milardi, Francesco , Murawa, Dawid , Menes, Tehillah S , Passeri, Daniele , Pastoriza, Jessica M , Perhavec, Andraz , Polidorio, Natália , Rami, Avina , Ugurlu, M Umit , van Hemert, Annemiek , Yoo, Tae-Kyung Robyn , Zhang, Jennifer Q , Peeters, Marie-Jeanne Vrancken , Morrow, Monica , Weber, Walter P , Wong, Stephanie M , Mrdutt, Mary M , Banys‐Paluchowski, Maggie , Boughey, Judy C. , Uras, Cihan , Karanlık, Hasan , Group, on behalf of the ICARO Study, Ahn, Sung Gwe , Corsi, Fabio , Crown, Angelena , Esposito, Emanuela , Fayanju, Oluwadamilola M. , Gentilini, Oreste D , Gülçelik, Mehmet Ali , Heil, Joerg , Leo, Cornelia , Pilewskie, Melissa , Riedel, Fabian , Rocco, Nicola , Schnabel, Freya Ruth , Singer, Christian F. , Soares, Leonardo Ribeiro , Tasoulis, Marios Konstantinos , Urban, Cicero A. , Vergauwen, Glenn , Wärnberg, Fredrik , Williams, Austin David
Journal of Clinical Oncology | November 7, 2024 | Volume: 43 | Issue: 7 | Pages: 810-820
PURPOSE The nodal burden of patients with residual isolated tumor cells (ITCs) in the sentinel lymph nodes (SLNs) after neoadjuvant chemotherapy (NAC) (ypN0i+) is unknown, and axillary management is not standardized. We investigated rates of additional positive lymph nodes (LNs) at axillary lymph node dissection (ALND) and oncologic outcomes in patients with ypN0i+ treated with and without ALND. METHODS The Oncoplastic Breast Consortium-05/ICARO cohort study (ClinicalTrials.gov identifier: NCT06464341 ) retrospectively analyzed data from patients with stage I to III breast cancer with ITCs in SLNs after NAC from 62 centers in 18 countries. The primary end point was the 3-year rate of any axillary recurrence. The rate of any invasive recurrence was the secondary end point. RESULTS In total, 583 patients were included, of whom 182 (31%) had completion ALND and 401 (69%) did not. The median age was 48 years. Most patients (74%) were clinically node-positive at diagnosis and 41% had hormone receptor–positive/human epidermal growth factor receptor 2–negative tumors. The mean number of SLNs with ITCs was 1.2. Patients treated with ALND were more likely to present with cN2/3 disease (17% v 7%, P < .001), have ITCs detected on frozen section (62% v 8%, P < .001), have lymphovascular invasion (38% v 24%, P < .001), and receive adjuvant chest wall (89% v 78%, P = .024) and nodal radiation (82% v 75%, P = .038). Additional positive nodes were found at ALND in 30% of patients, but only 5% had macrometastases. The 3-year rates of any axillary and any invasive recurrence were 2% (95% CI, 0.95 to 3.6) and 11% (95% CI, 8 to 14), respectively, with no statistical difference by type of axillary surgery. CONCLUSION The nodal burden in patients with ypN0(i+) was low, and axillary recurrence after ALND omission was rare in patients selected for this approach. These results do not support routine ALND in all patients with ypN0(i+).