Identifying research gaps in PIK3CA-mutant breast cancer: a bibliometric analysis of evolving trends and clinical applications.

Phosphatidylinositol-4,5-bisphosphate 3-kinase catalytic subunit alpha (PIK3CA) mutations are among the most common genetic alterations in breast cancer and have important implications for tumor biology, subtype-specific behavior, and targeted therapy. This study provides a comprehensive bibliometric analysis of global research on PIK3CA mutations in breast cancer, highlighting critical research hotspots and evolving trends. We aim to address the current lack of an integrated understanding in this vital area. Publications related to PIK3CA and breast cancer from 2000 to 2024 were retrieved from the Web of Science Core Collection. Bibliometric cluster analyses were performed using VOSviewer, CiteSpace, and R-bibliometrix to delineate collaboration networks, journal distributions, and thematic clusters. A total of 2,135 publications were analyzed, predominantly from the US, China, and the UK. Harvard University and Unicancer emerged as leading institutions, with significant contributions from authors such as Gordon B. Mills and Jorge S. Reis-Filho. Keyword analysis identified six major research hotspots, categorized into basic research (molecular mechanisms, signaling pathways, genomics, biomarkers, tumor biology) and clinical research (clinical trials, therapeutic strategies, cancer subtypes, drug resistance, tumor microenvironment). Citation burst analysis indicated an early focus on molecular mechanisms and gene mutations, while recent studies have shifted toward precision medicine, including liquid biopsy, advanced breast cancer subtypes, and targeted therapies such as alpelisib and fulvestrant, reflecting evolving priorities toward personalized treatment. This bibliometric study identifies six key research hotspots in PIK3CA and breast cancer, demonstrating the transition from basic mechanisms to clinical applications. Recent research trends, including liquid biopsy, advanced subtypes, and combination therapies, are closely tied to precision medicine and individualized treatment approaches.