Improved response rates shown with neoadjuvant and adjuvant pembrolizumab for triple‐negative breast cancer with lymph node involvement

Cancer ◽  
2020 ◽  
Vol 126 (9) ◽  
pp. 1827-1827
Author(s):  
Carrie Printz
2018 ◽  
Vol 12 ◽  
pp. 117955491879056 ◽  
Author(s):  
Homero Gonçalves ◽  
Maximiliano Ribeiro Guerra ◽  
Jane Rocha Duarte Cintra ◽  
Vívian Assis Fayer ◽  
Igor Vilela Brum ◽  
...  

Objective: To analyze the clinical, pathological, and sociodemographic aspects between triple-negative breast cancer (TNBC) and non-TNBC in a Brazilian cohort and identify potential prognostic factors. Methods: This hospital-based retrospective cohort study included 447 women with breast cancer treated at referral centers in Southeastern Brazil. Overall and disease-free survival were compared; prognostic factors were evaluated. Results: Triple-negative breast cancer corresponded to 19.5% of breast cancer diagnosis and was more prevalent among nonwhite and less educated women. The patients with TNBC tended to present with stage III cancer, high p53 expression, lymphocytic infiltration, and multifocality and treated with radical surgery and chemotherapy. The 5-year overall and disease-free survival were 62.1% and 57.5% for TNBC and 80.8% and 75.3% for non-TNBC, respectively ( P < .001). The TNBC recurrence was associated with multicentricity, whereas lymph node involvement increased the risk of both recurrence and death. Non-TNBC worse clinical course was associated with nonwhite ethnicity, lower education level, lymph node involvement, and advanced stage. Conclusions: Triple-negative breast cancer exhibited a more aggressive behavior, earlier and more frequent recurrence, and worse survival compared with non-TNBC. While biological and social variables were associated with poorer prognosis in non-TNBC, only lymph node involvement and multicentricity were correlated with worse clinical outcomes in TNBC.


2020 ◽  
Vol 38 (15_suppl) ◽  
pp. e13110-e13110
Author(s):  
Narayanankutty Edavalath Warrier ◽  
Uma V Sankar ◽  
Sreedharan P S ◽  
Ajmal Sherif

e13110 Background: The heterogeneity of breast cancer explains in part the differences in the morbidity and mortality of this disease. Triple-negative breast cancer (TNBC) is a specific subset of tumors characterized by the absence of the 3 most commonly targeted biomarkers considered for breast cancer treatment: Estrogen receptor (ER), progesterone receptor (PR), and human epidermal growth factor receptor (HER2). TNBC accounts for 15% to 20% of all breast cancer diagnoses and usually has a more aggressive clinical course, with worse evolution within the first 3 to 5 years after diagnosis; early and higher rates of distant recurrences, typically visceral; and poor survival. Methods: To analyze the clinical, pathological, and sociodemographic aspects between triple-negative breast cancer (TNBC) and non-TNBC in a Kerala cohort and identify potential prognostic factors. This hospital-based retrospective cohort study (From January 2017 till December 2018) included 465 women with breast cancer treated at MVR Cancer Centre & Research Institute in North Kerala. Overall and disease-free survival was compared; prognostic factors were evaluated. Results: Triple-negative breast cancer corresponded to 16.3% of breast cancer diagnosis and was more prevalent among rural women. The patients with TNBC tended to present with stage III cancer, high p53 expression, lymphocytic infiltration, and multifocality and treated with radical surgery and chemotherapy. The 2-year overall and disease-free survival were 52.1% and 43.5% for TNBC and 83.8% and 73.4% for non-TNBC, respectively ( P < .001). The TNBC recurrence was associated with multicentricity, whereas lymph node involvement increased the risk of both recurrence and death. Non-TNBC worse clinical course was associated with rural women, younger age, lymph node involvement, and advanced stage. Conclusions: Triple-negative breast cancer exhibited a more aggressive behavior, earlier and more frequent recurrence, and worse survival compared with non-TNBC. While biological and social variables were associated with poorer prognosis in non-TNBC, only lymph node involvement and multicentricity were correlated with worse clinical outcomes in TNBC.


2021 ◽  
Author(s):  
Thanaa Helal ◽  
Joaira Bakkach ◽  
Hagar Elghazawy ◽  
Ahmed Aref ◽  
Mohamed Kelany ◽  
...  

Abstract Background Triple negative breast cancer (TNBC) is an aggressive subtype of breast cancer (BC) with ill-defined therapeutic targets. Androgen receptor (AR) and tumor-infiltrating lymphocytes (TILs) had a prognostic and predictive value in TNBC. The relationship between AR, TILs and clinical behavior is still not fully understood. Methods Thirty-six TNBC patients were evaluated for AR (positive if ≥ 1% expression), CD3, CD4, CD8 and CD20 by immunohistochemistry. Stromal TILs were quantified following TILs Working Group recommendations. Lymphocyte-predominant breast cancer (LPBC) was defined as having stromal TILs ≥ 50%, whereas lymphocyte-deficient breast cancer (LDBC) was defined as < 50%. Results The mean age was 52.5 years and 27.8% were ≥ 60 years. Seven patients (21.2%) were AR+. All AR + cases were postmenopausal (≥ 50 years old). No statistical difference was found in median overall survival (OS) between AR- and AR + groups (31.5 vs. 25 months, p = 0.77). LPBC was 32.2%. Median TILs was 37.5% and 10% (p = 0.1) and median CD20 was 20% and 7.5% (p = 0.008) in AR- and AR+, respectively. Mean CD3 was 80.7% and 93.3% (p = 0.007) and CD8 was 75% and 80.8% (p = 0.41) in AR- and AR + respectively. All patients who were ≥ 60 years old expressed CD20. LDBC was found to be significantly higher in N + vs. N- patients (p = 0.03) with median TILs of 20% vs. 50% in N + vs. N-, respectively (p = 0.03). LDBC was associated with higher risk of lymph node involvement (OR = 6, 95% CI = 1.05–34.21, p = 0.04). Conclusions AR expression was evident in older age (≥ 50 years). Median CD20 was higher in AR- TNBC, while mean CD3 was higher in AR + tumors. LDBC was associated with higher risk of lymph node involvement. Larger studies are needed to focus on the clinical impact of the relation between AR and TILs in TNBC.


2013 ◽  
Vol 31 (15_suppl) ◽  
pp. 1038-1038
Author(s):  
Jaskirat Singh Randhawa ◽  
Vyshak Alva Venur ◽  
Hameem Kawsar ◽  
Timothy Peter Spiro ◽  
Abdo S. Haddad ◽  
...  

1038 Background: Triple-negative (estrogen/progesterone-receptors negative and HER2-negative; TNBC) and Triple-positive (estrogen/progesterone-receptors positive and HER2-positive; TPBC) breast cancers are very distinctive in terms of tumor behavior as well as disease management. Due to lack of an effective targeted therapy, the treatment options are limited for TNBC. We conducted a retrospective review to compare various characteristics and recurrence outcome in TNBC and TPBC. Methods: Over 3000 non-consecutive female breast cancer patients (diagnosed between 2000-2012) were reviewed. Of these, 406 patients (206 TNBC, 200 TPBC) were included. The following data at diagnosis were studied: age, tumor size, stage, grade, lymph node involvement, distant metastases and smoking history. Analyses are performed using R statistical software (Version 2.15.2). Numeric data are summarized by median and quartile with comparisons between groups performed by Wilcoxon Rank Sum Tests. Categorical data are summarized by frequency and percentage and comparisons between groups are performed by chi-square tests. Statistical significance is determined by a p-value ≤ 0.05. Results: Both TNBC and TPBC were diagnosed at similar median ages of 56.5 and 55 years respectively (p= 0.059). TNBC were more likely to have poorly differentiated histology (75.63%) whereas TPBC were more often moderately differentiated (54.79%) (p< 0.001). At diagnosis, Triple-Positive (TP) tumors were larger (median 2.4 cm) compared to Triple-Negative (TN) tumors (median 2 cm) (p= 0.013). However, there were no significant differences with respect to lymph node involvement and distant metastases in the two groups. Importantly, recurrences were more common in TNBC 33.85% (65/192) compared to TPBC 4.21% (8/190) (p < 0.001) and there was no association found with smoking history or active smoking status. Conclusions: TN tumors although smaller in size compared to TP were more likely to have poorly differentiated histology, showed higher recurrence rates and therefore were more aggressive in behavior. Both TNBC and TPBC were diagnosed at similar median age and exhibited no recurrence association with smoking history.


2019 ◽  
Vol 48 (3) ◽  
pp. 030006051988725
Author(s):  
Monika Sobočan ◽  
Maja Turk ◽  
Pija Čater ◽  
Nina Čas Sikošek ◽  
Bojana Crnobrnja ◽  
...  

Objective Clinical and pathological characteristics of triple negative breast cancer (TNBC) treatment are required for escalation or de-escalation of treatment because of a lack of druggable targets. This study aimed to identify the factors affecting the risk of disease recurrence and disease-related death in patients with TNBC. Methods Patients with TNBC who were treated at the University Medical Centre Maribor between January 2010 and December 2017 were studied. Clinical and pathological data were analyzed using multivariate analysis and non-parametric tests. Subgroup analysis was performed to examine additional factors that affect 5-year overall survival (OS) and recurrence-free survival. Results Multivariate analysis showed that tumor size and the lymph node ratio (LNR) were significant risks in our population. Better discrimination of patients at risk of a shorter recurrence-free survival and OS was achieved by using the LNR. Only lymphovascular invasion was significant for predicting 5-year OS. Conclusion For risk-based decision-making systems, the LNR is useful for discriminating between high- and low-risk patients with TNBC.


2021 ◽  
pp. 41-44
Author(s):  
R. Rani Suganya ◽  
M. Annapoorani ◽  
C. Naveen Kumar

Breast cancer is the major health problem for the women throughout the world.Management of breast cancer has evolved to include both surgery for local disease and medical therapy for systemic disease. Multiple treatment options are available depending on various factors such as histological grade, hormone receptor status etc. The aim of this study is to correlate the hormone receptor status with prognostic factors such as lymph node involvement, tumour grading and age among patients diagnosed with breast cancer in our institution. The results of this study serve to prognosticate the severity of disease among various strata of patients.


2020 ◽  
Author(s):  
Madiha Liaqat ◽  
Shahid Kamal ◽  
Florian Fischer ◽  
Nadeem Zia

Abstract Background: Involvement of lymph nodes has been an integral part of breast cancer prognosis and survival. This study aimed to explore factors influencing on the number of auxiliary lymph nodes in women diagnosed with primary breast cancer by choosing an efficient model to assess excess of zeros and over-dispersion presented in the study population. Methods: The study is based on a retrospective analysis of hospital records among 5,196 female breast cancer patients in Pakistan. Zero-inflated Poisson and zero-inflated negative binomial modeling techniques are used to assess the association between under-study factors and the number of involved lymph nodes in breast cancer patients. Results: The most common breast cancer was invasive ductal carcinoma (54.5%). Patients median age was 48 years, from which women aged 46 years and above are the majority of the study population (64.8%). Examination of tumors revealed that over 2,662 (51.2%) women were ER-positive, 2,652 (51.0%) PR-positive, and 2,754 (53.0%) were Her2.neu-positive. The mean tumor size was 3.06 cm and histological grade 1 (n=2021, 38.9%) was most common in this sample. The model performance was best in the zero-inflated negative binomial model. Findings indicate that most factors related to breast cancer have a significant impact on the number of involved lymph nodes. Age is not contributed to lymph node status. Women having a larger tumor size suffered from greater number of involved lymph nodes. Tumor grades 11 and 111 contributed to higher numbers of positive lymph node.Conclusions: Zero-inflated models have successfully demonstrated the advantage of fitting count nodal data when both “at-harm” (lymph node involvement) and “not-at-harm” (no lymph node involvement) groups are important in predicting disease on set and disease progression. Our analysis showed that ZINB is the best model for predicting and describing the number of involved nodes in primary breast cancer, when overdispersion arises due to a large number of patients with no lymph node involvement. This is important for accurate prediction both for therapy and prognosis of breast cancer patients.


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