Development and validation of a LASSO-derived nomogram for predicting unfavorable treatment outcomes in drug-resistant pulmonary tuberculosis.

According to the latest data released by the WHO in 2024, 2.3 million females worldwide were diagnosed with breast cancer by 2022, with 670,000 deaths attributable to the disease. In the United States, breast cancer surpassed lung cancer as the most frequently diagnosed cancer among females. Breast cancer accounts for 15% of all cancer-related deaths, and was the second leading cause of mortality []. In China, the incidence rate of breast cancer among females reached 15.6%, second only to lung cancer. Although the global incidence rate of breast cancer has continued to rise in the past 20 years, the survival rate has improved significantly due to advancements in treatment modalities []. This positive shift results from the development and improvement of these treatments. Currently, common treatment modalities for breast cancer include surgery (such as mastectomy), chemotherapy, radiotherapy, targeted therapy, immunotherapy, and endocrine therapy. Among these, adjuvant chemotherapy following mastectomy is the most commonly used method, and could effectively reduce the risk of metastasis and cancer cell dissemination. This results in improved prognostic outcomes, with a 5-year survival rate extending up to 82.0% []. This surgical-based treatment approach is more suitable for early-stage patients []. However, despite its efficacy in preventing metastasis and enhancing patient survival rates, postoperative adjuvant chemotherapy imposes a tremendous financial burden on patients during disease treatment and recovery, which ultimately leads to financial toxicity [–]. Financial toxicity (FT) refers to the negative impact of the high costs associated with the treatment of cancer patients, encompassing both objective and subjective financial difficulties. The objective hardship of financial toxicity mainly includes direct expenses, such as medical costs, and indirect expenses, such as lost income and transportation costs incurred during treatment []. The subjective distress of financial toxicity includes emotional and mental health issues, such as anxiety and depression. These challenges can reduce treatment adherence, increase the fear of cancer recurrence (FCR), and thus affect the patient’s QOL [–]. FCR is defined as the concern regarding cancer recurrence or progression, and is one of the key factors leading to a significant decline in patients’ QOL [, ]. Notably, breast cancer patients report higher levels of financial toxicity and elevated scores associated with the FCR [–]. Despite the continuous development of breast cancer treatment technologies, tumor recurrence and metastasis remain major challenges in modern medicine. Even breast cancer patients with small tumor diameters and negative lymph nodes have a recurrence risk of approximately 10% []. Therefore, addressing the FCR has positive implications for all breast cancer patients. Increased social and psychological stress, along with financial toxicity, have contributed to a more pronounced negative illness perception (IP) in breast cancer patients, severely affecting their QOL [–]. The concept of IP was defined by Howard Leventhal et al. in 1980 as the knowledge and beliefs that individuals hold about symptoms, pain, illness, medical conditions, and health threats. Research indicates that IP analyses can improve psychological states and health outcomes, thereby affecting patients’ QOL [].