Increased cardio and cerebrovascular mortality in breast cancer patients treated with postmastectomy radiotherapy – 25year follow-up of a randomised trial from the South Sweden Breast Cancer Group

The levels of CA 549 and SP2 were measured in 430 subjects: 100 healthy blood donors, 130 patients with benign diseases and 200 postoperative breast cancer patients. In the latter group, the serum levels of CA 15.3, CEA and TPA were also measured. The Kolmogorov-Smirnov, Mann Whitney and McNemar tests were used for statistical analysis. The upper normal limits were established on the basis of the values obtained in the healthy blood donors group, the benign diseases group and R.O.C. analysis of the breast cancer group. They were: CA 549 = 13 U/ml, SP2 = 14 U/ml, CA 15.3 = 35 U/ml, CEA = 5 ng/ml and TPA = 110 U/ml. The sensitivity, specificity and accuracy in the breast cancer group were, respectively: CA 549 = 78.1%, 97.1% and 88%; SP2 = 21.9%, 90.4% and 57.5%; CEA = 66.7%, 95.2% and 81.5%; CA 15.3 = 80.2%, 98.1% and 89.5%, and TPA = 73.9%, 78.8% and 76.5%. Statistical analysis showed significant differences only between CA 15.3, the marker which gave the best results, and SP2 (p<0.001). There were no significant differences with the association of two or three tumor markers.

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Diethylstilbestrol: recommended dosages for different categories of breast cancer patients. Report of the Cooperative Breast Cancer Group

JAMA ◽

10.1001/jama.237.19.2079 ◽

1977 ◽

Vol 237 (19) ◽

pp. 2079-2078 ◽

Cited By ~ 12

Author(s):

A. C. Carter

Keyword(s):

Breast Cancer ◽

Cancer Patients ◽

Breast Cancer Patients ◽

Cancer Group ◽

Breast Cancer Group

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Outcome of breast cancer patients treated with chemotherapy during pregnancy compared with non-pregnant controls.

Journal of Clinical Oncology ◽

10.1200/jco.2021.39.15_suppl.515 ◽

2021 ◽

Vol 39 (15_suppl) ◽

pp. 515-515

Author(s):

Frederic Amant ◽

Valentina Nekljudova ◽

Charlotte Maggen ◽

Fenja Seither ◽

Patrick Neven ◽

...

Keyword(s):

Breast Cancer ◽

Cancer Patients ◽

Hormone Receptor ◽

Proportional Hazards ◽

Cox Proportional Hazards ◽

Breast Cancer Patients ◽

Cancer Data ◽

Cancer Group ◽

Breast Cancer Group ◽

Grade 3

515 Background: Overall a diagnosis of breast cancer during pregnancy (BCP) appears not to impact maternal prognosis if standard treatment is offered. However, caution is warranted as gestational changes in pharmacokinetics with respect to the distribution, metabolism and excretion of drugs may lead to reduced chemotherapy concentration in pregnant patients. This cohort study was designed to focus on the maternal prognosis of BCP patients that receive chemotherapy during pregnancy. Methods: The outcome of BCP patients treated with chemotherapy during pregnancy was compared to non-pregnant breast cancer patients treated with chemotherapy, diagnosed after 2000, excluding postpartum diagnosis and with an age limit of 45 years. The data was registered by two multicentric registries (the International Network of Cancer, Infertility and Pregnancy and the German Breast Cancer Group) that collect both retro-and prospectively breast cancer data. Cox proportional hazards regression was used to compare disease-free (DFS) and overall survival (OS) between both groups, adjusting for age, stage, grade, hormone receptor status, human epidermal growth factor 2 status and histology, weighted by propensity scoring in order to account for the differences in baseline characteristics between pregnant patients and controls. Results: In total, 662 pregnant and 2081 non-pregnant patients, were eligible for analysis. Median age at diagnosis was 34 (range 22-47) years for pregnant and 38 (range 19-45) years for non-pregnant patients. Pregnant patients were more likely to have stage II breast cancer (60.1% vs 56.1%, p = 0.035), grade 3 tumors (74.0% vs 62.2%, p < 0.001), hormone receptor-negative tumors (48.4% vs 34.0%, p < 0.001) or triple-negative breast cancer (38.9% vs 26.9%, p < 0.001). Median follow-up was 66 months. DFS and OS were comparable for pregnant and non-pregnant patients (DFS: HR 1.02, 95%CI 0.82-1.27, p = 0.83; OS: HR 1.08, 95% CI 0.81-1.45, p = 0.59). A subgroup analysis of 339 women that received more than 60% of chemotherapy during pregnancy (cut-off at median) revealed a comparable survival compared to non-pregnant women (DFS: HR 0.81, 95%CI 0.62-1.06, p = 0.13; OS: HR 0.85 95% CI 0.58-1.23, p = 0.39). Conclusions: Pregnancy-induced alternations in chemotherapy concentration do not seem to affect maternal prognosis in breast cancer patients. These results support initiation of chemotherapy for BCP where indicated for oncological reasons.

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Chronological Skin Changes Through Postmastectomy Radiotherapy Based on Radiotherapy Techniques: Using Quantitative Dermatological Measurements

Skin Pharmacology and Physiology ◽

10.1159/000515962 ◽

2021 ◽

pp. 1-10

Author(s):

Kyungmi Yang ◽

Won Park ◽

Juhee Cho ◽

Danbee Kang ◽

Doo Ho Choi ◽

...

Keyword(s):

Breast Cancer ◽

Cancer Patients ◽

Radiation Dermatitis ◽

Breast Cancer Patients ◽

Mixed Effect ◽

Postmastectomy Radiotherapy ◽

Effect Model ◽

Patient Reported ◽

Grade 3

Background: There has been few research on how to measure skin status quantitatively throughout the course of radiotherapy (RT). We evaluated the changes in the skin induced by 2 different RT techniques using objective measurements in breast cancer patients. Methods: In this prospective study, between August 2015 and March 2019, serial measurements of the dermatological factors during and after postmastectomy radiotherapy (PMRT) were made in 40 breast cancer patients. PMRT was performed using the conventional photon tangential technique (PTT) or patient-tailored bolus technique (PTB). We analyzed these measurements using a mixed effect model and compared the clinically evaluated radiation dermatitis and patient-reported outcomes (PROs). Results: The trend of changes in melanin and erythema was significantly different between the PTB and PTT groups (p = 0.045 and 0.016, respectively). At the 3-month follow-up erythema intensity and melanin were higher in the PTB group than in PTT group (both p < 0.001). Eight patients (40% in the PTB group) reported grade 2 radiation dermatitis and 1 patient (5% in the PTB group) reported grade 3 radiation dermatitis. No grade 2 or higher radiation dermatitis was found in the PTT group. Ten patients (50%) in the PTB group and 3 patients (15%) in the PTT group reported severe erythema likely due to questionable clinical evaluation, but hyperpigmentation was rarely reported at the follow-up visits. Conclusion: The PTB group showed higher intensity of erythema at the end of RT than the PTT group and the increase in melanin lasted until the 3-month follow-up visits in the PTB group. Moreover, patients subjectively appealed more severe symptoms following PTB in PROs.

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Complete hormonal blockade versus epirubicin-based chemotherapy in premenopausal, one to three node-positive, and hormone-receptor positive, early breast cancer patients: 7-year follow-up results of French Adjuvant Study Group 06 randomised trial

Annals of Oncology ◽

10.1093/annonc/mdl107 ◽

2006 ◽

Vol 17 (8) ◽

pp. 1221-1227 ◽

Cited By ~ 50

Author(s):

H. Roché ◽

P. Kerbrat ◽

J. Bonneterre ◽

P. Fargeot ◽

P. Fumoleau ◽

...

Keyword(s):

Breast Cancer ◽

Cancer Patients ◽

Early Breast Cancer ◽

Hormone Receptor ◽

Randomised Trial ◽

Study Group ◽

Breast Cancer Patients ◽

Node Positive ◽

Hormone Receptor Positive

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Risk of coronary artery disease after adjuvant radiotherapy in 29,662 early breast cancer patients: A population-based Danish Breast Cancer Group study

Radiotherapy and Oncology ◽

10.1016/j.radonc.2021.01.010 ◽

2021 ◽

Vol 157 ◽

pp. 106-113 ◽

Cited By ~ 1

Author(s):

Marie Louise Holm Milo ◽

Lise Bech Jellesmark Thorsen ◽

Søren Paaske Johnsen ◽

Kirsten Melgaard Nielsen ◽

Jan Brink Valentin ◽

...

Keyword(s):

Breast Cancer ◽

Coronary Artery Disease ◽

Coronary Artery ◽

Cancer Patients ◽

Adjuvant Radiotherapy ◽

Population Based ◽

Breast Cancer Patients ◽

Cancer Group ◽

Breast Cancer Group ◽

Artery Disease

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Conventional versus hypofractionated postmastectomy radiotherapy: a report on long-term outcomes and late toxicity

Radiation Oncology ◽

10.1186/s13014-019-1378-x ◽

2019 ◽

Vol 14 (1) ◽

Cited By ~ 3

Author(s):

Imjai Chitapanarux ◽

Pitchayaponne Klunklin ◽

Attapol Pinitpatcharalert ◽

Patumrat Sripan ◽

Ekkasit Tharavichitkul ◽

...

Keyword(s):

Breast Cancer ◽

Cancer Patients ◽

Late Toxicity ◽

Breast Cancer Patients ◽

Long Term Outcomes ◽

Postmastectomy Radiotherapy ◽

Free Survival ◽

Significant Difference

Abstract Objective We evaluated the long-term outcomes and late toxicity of conventional fractionated (CF) and hypofractionated (HF) postmastectomy radiotherapy (PMRT) in terms of locoregional recurrence-free survival (LRRFS), disease-free survival (DFS), overall survival (OS), and late toxicity. Methods A cohort of 1640 of breast cancer patients receiving PMRT between January 2004 and December 2014 were enrolled. Nine hundred eighty patients were treated with HF-PMRT: 2.65 Gy/fraction to a total of 42.4–53 Gy and 660 patients were treated with CF-PMRT: 2 Gy/fraction to a total of 50–60 Gy. Results The median follow-up time was 71.8 months (range 41.5–115.9 months). No significant difference was found in the rates of 5-year LRRFS, DFS, and OS of HF-PMRT vs CF-PMRT; 96% vs. 94% (p = 0.373), 70% vs. 72% (p = 0.849), and 73% vs. 74% (p = 0.463), respectively. We identified a cohort of 937 eligible breast cancer patients who could receive late toxicities assessment. With a median follow-up time of this patient cohort of 106.3 months (range 76–134 months), there was a significant higher incidence of grade 2 or more late skin (4% vs 1%) and subcutaneous (7% vs 2%) toxicity in patients treated with HF-PMRT vs CF-PMRT. Patients who received additional radiation boost were significantly higher in the HF-PMRT group. Grade 2 or more late RTOG/EORTC lung toxicity was significant lesser in HF-PMRT vs CF-PMRT (9% vs 16%). Grade 1 brachial plexopathy was also significant lesser in HF-PMRT vs CF-PMRT (2% vs 8%). Heart toxicity and lymphedema were similar in both groups. Conclusions HF-PMRT is feasible to deliver with comparable long-term efficacy to CF-PMRT. HF-PMRT had higher grade 2 or more skin and subcutaneous toxicity but less lung and brachial plexus toxicity.

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