Second primary tumors (SPTs) occur in approximately 10% of patients following an initial cancer diagnosis and are associated with increased cancer-related mortality. Ongoing advancements in systemic therapies have led to a growing population of both breast cancer (BC) survivors and patients living with metastatic disease. Consequently, individuals with BC face a heightened risk of developing SPTs and second primary breast cancers (SPBC), with a reported 25-year cumulative incidence of contralateral BC of about 10%. Here we present real-world data on SPTs and SPBC in patients with metastatic breast cancer (MBC) derived from the Austrian Study Group of Medical Tumor Therapy (AGMT) MBC-Registry. The AGMT_MBC-Registry is a multicenter, nationwide, ongoing retrospective and prospective registry capturing data from MBC patients across Austria. For this analysis, only patients with documented information on the presence or absence of SPTs were included. The analysis of SPBC was limited to patients with known tumor location and diagnosis date. To avoid misclassification, no distinction was made between local recurrences and ipsilateral SPBC. Bilateral BC was defined as cancer diagnosed in both breasts within 90 days. As of June 26, 2024, the AGMT_MBC-Registry included 2,850 patients. Among 2,630 evaluable patients, 225 (8.6%) were diagnosed with a SPT, with 12% (27/225) of these having more than one SPT. Most SPTs were diagnosed after the initial BC diagnosis but prior to the development of metastatic disease. A total of 260 malignancies were reported: 88% were solid tumors and 12% hematologic. The most frequent solid tumors were colorectal cancer, melanoma, and lung cancer, while non-Hodgkin lymphoma and acute leukemia were the most common hematologic malignancies ( Table 1 ). Among 2,576 evaluable patients, 533 (20.7%) experienced a SPBC: 145/533 (27.2%) contralateral, 287/533 (53.8%) ipsilateral, and 101/533 (18.9%) initially presented with bilateral BC. In this real-world analysis of patients with MBC, 9% were diagnosed with SPT and 21% experienced a SPBC. These findings highlight the critical role of histopathological verification of suspicious lesions and metastases and underscore the importance of continued awareness for SPTs - not only among BC survivors but also in patients with metastatic disease Table 1: V. Castagnaviz, S. P. Gampenrieder, A. Pichler, W. Herz, R. Pusch, C. Dormann, C. Suppan, M. Sandholzer, T. Winder, S. Heibl, L. Scagnetti, C. Schmitt, A. F. Zabernigg, D. Egle, C. Hager, P. Pichler, F. Roitner, J. Andel, K. Strasser-Weippl, R. Bartsch, M. Hubalek, M. Knauer, C. F. Singer, G. Rinnerthaler, R. Greil. Incidence of second primary tumors and second primary breast cancers events in patients with metastatic breast cancer: results from the Austrian AGMT_MBC-Registry [abstract]. In: Proceedings of the San Antonio Breast Cancer Symposium 2025; 2025 Dec 9-12; San Antonio, TX. Philadelphia (PA): AACR; Clin Cancer Res 2026;32(4 Suppl):Abstract nr PS2-04-08.
Elacestrant is the first oral Selective Estrogen Receptor Degrader (SERD) to be approved in the EU as of September 2023. Since its approval, testing for mutations in the estrogen receptor 1 (ESR1) gene has become standard care for patients with hormone receptor (HR)-positive, HER2-negative metastatic breast cancer (MBC) in low- to intermediate risk disease. ESR1 mutations are a known mechanism of resistance to aromatase inhibitors (AIs), with their frequency significantly increasing after AI treatment. This study presents the first real-world data from the Austrian Study Group of Medical Tumor Therapy (AGMT) MBC Registry regarding ESR1 testing and elacestrant use. The AGMT MBC Registry is a nationwide, multicenter, ongoing retrospective and prospective registry for MBC patients in Austria. For this analysis, only patients with sufficient data quality were included. ESR1 mutation testing was performed using various techniques and test kits, following local practices. As of March 11, 2025, the registry included 3,094 patients, of whom 2,956 were evaluable. Among these, 132 patients (4.5%) had documented ESR1 testing. A total of 59 tests were performed on 54 patients after the approval of elacestrant: 33 (55.9%) via liquid biopsy and 26 (44.1%) via tissue analysis; three tests in three patients had no or inconclusive results. The majority of patients had HR+/HER2- disease (n=48; 92.3%). A total of 14 patients (27.5%) had a positive ESR1 result (30.4% of all tests). Six distinct ESR1 mutations were identified: D538G, E380Q, Y537S, Y537N, M396V, and L536_D538>P. Notably, three patients (5.5%) had multiple ESR1 mutations. These combinations were: E380Q/Y537S/M396V, D538G/E380Q, and D538G/Y537N. Of the 14 patients with positive ESR1 test results, 7 patients (50.0%) initiated elacestrant treatment between the first and eleventh line of therapy, with five patients continuing treatment at the data cut-off. Updated outcome data will be presented at the meeting.Eleven, 8 and 9 patients with ESR1 mutations (n=14) had additional testing for PIK3CA, TP53 and for BRCA1/2, respectively. In 7 patients co-mutations in PIK3CA were found. Four of these patients were treated with a PI3-kinase inhibitor, and one received elacestrant in combination with alpelisib. Co-mutations with TP53 and BRCA2 were found in 3 and 1 patient, respectively. This real-world data highlights the clinical relevance of ESR1 mutations in HR+/HER2- metastatic breast cancer patients and underscores the potential impact of molecular-guided treatment. The association of ESR1 mutations with co-mutations in PIK3CA, TP53, and BRCA2 suggests the need for personalized treatment approaches. Further follow-up and outcome data will provide more insights into the long-term efficacy of elacestrant in this cohort. S. P. Gampenrieder, G. Rinnerthaler, A. Pichler, W. Herz, R. Pusch, C. Dormann, C. Suppan, M. Sandholzer, T. Winder, S. Heibl, L. Scagnetti, C. Schmitt, A. F. Zabernigg, D. Egle, C. Hager, P. Pichler, F. Roitner, J. Andel, K. Strasser-Weippl, R. Bartsch, V. Castagnaviz, M. Hubalek, M. Knauer, C. F. Singer, R. Greil. Esr1 mutations and use of the oral serd elacestrant in metastatic breast cancer patients in austria: results from the agmt_mbc-registry [abstract]. In: Proceedings of the San Antonio Breast Cancer Symposium 2025; 2025 Dec 9-12; San Antonio, TX. Philadelphia (PA): AACR; Clin Cancer Res 2026;32(4 Suppl):Abstract nr PS1-11-26.
We present a time-efficient, clinically integrated lung ultrasound protocol tailored for prehospital use by providers not yet routinely using ultrasound. Specifically designed to support the recognition of pneumothorax and interstitial syndrome, the protocol emphasizes operational feasibility, spectrum-based diagnostic reasoning, and strict time limitations to avoid delays in definitive care. It includes standardized scanning sequences, documentation, and a governance framework for training, certification, and quality assurance. Developed and implemented in an Austrian ambulance service, it may serve as a scalable model for expanding ultrasound access. A prospective registry supports the evaluation of feasibility, image quality, diagnostic yield, and clinical impact.
IntroductionIn Austria, a nationwide antigen-test-based screening program for all students and educational staff in combination with intensified non-pharmaceutical mitigation measures were initiated in February 2021. We analyzed the first 6 weeks of this program and its impact on the prevalence of asymptomatic SARS-CoV-2 carriers.MethodsDuring the study period, we evaluated the results of 1 million students and approximately 150,000 educational staff members performing self-collected anterior-nasal swabs for antigen self-tests (ANAST) 1 to 3 times a week. Prevalence of asymptomatic SARS-CoV-2 carriers was monitored by an RT-qPCR based surveillance study in a representative school cohort.ResultsDuring the 6 weeks period, 6.979 persons tested positive by ANAST, corresponding to a weekly positivity rate of median 0.08% (range 0.04–0.13) and 0.22% (range 0.12–0.30) for students and educational staff, respectively. Compared to students, staff members had a significantly higher chance of testing positive in all analyzed weeks with odds ratios (OR) up to 3.4 (95% CI: 3.0–3.8). Per week a total of 78.5–89.7% (median 84.1%) of positive ANASTs were reported as isolated cases. Evaluating the prevalence of asymptomatic SARS-CoV-2 carriers with a model adjusted for regional community incidence, the OR for having an RT-qPCR-detected SARS-CoV-2 infection after initiation of the screening program compared to earlier periods was 0.31 (95% CI 0.17–0.54; p < 0.001).DiscussionThe screening program detected a considerable number of screening-positive individuals. Their prevalence was significantly lower during the screening program consistent with a potential contribution of in-school screening programs to reducing the spread of SARS-CoV-2 in educational settings.
