Assessing the impact of CMF-like/Anthracycline-based/Anthracycline-Taxane-based/dose-dense chemotherapy in dependency of positive axillary lymph nodes/hormone receptor-status/grading/T-stage on survival – A retrospective multi-centre cohort study of 3677 patients receiving adjuvant chemotherapy

2014 ◽  
Vol 50 (17) ◽  
pp. 2905-2915 ◽  
Author(s):  
L. Schwentner ◽  
A. Wöckel ◽  
J. König ◽  
W. Janni ◽  
M. Blettner ◽  
...  
Keyword(s):  
Cohort Study ◽  
Adjuvant Chemotherapy ◽  
Lymph Nodes ◽  
Hormone Receptor ◽  
Hormone Receptor Status ◽  
Axillary Lymph Nodes ◽  
Axillary Lymph ◽  
Receptor Status ◽  
Dose Dense ◽  
The Impact

Assessing the impact of CMF/FEC/FEC-DOC/ETC (dose-dense) adjuvant chemotherapy in dependency of positive axillary lymph nodes on survival: A retrospective multicenter cohort study of 4,526 breast cancer patients receiving adjuvant chemotherapy.

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. 1074-1074
Author(s):  
Lukas Schwentner ◽  
Reyn Van Ewijk ◽  
Isabell Hoffmann ◽  
Rolf Kreienberg ◽  
Maria Blettner ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cohort Study ◽  
Adjuvant Chemotherapy ◽  
Lymph Nodes ◽  
Significant Benefit ◽  
Axillary Lymph ◽  
Dose Dense ◽  
The Impact ◽  
Positive Lymph Nodes ◽  
Positive Breast Cancer

1074 Background: Adjuvant chemotherapy has changed dramatically in the last decades. Anthracycline-/taxane-based and dose-dense chemotherapy regimens improved survival in node positive breast cancer. This study tries to answer the following questions: (1) Are there differences in survival dependent on chemotherapy regimens in 0/0-3/4-10/<10 positive lymph nodes? (2) Is it possible to define a cut-off of positive lymph nodes for the use of Taxane-based and dose dense chemotherapy? Methods: This German is a multi-center [17 participating hospitals all are certified as breast cancer centers] retrospective cohort study. We included CMF (1.385), FEC (1.170), FEC-DOC (1.723), and dose-dense ETC (248) into the analysis. Results: In case of 0 LN CMF/FEC/FEC-DOC did not show significant differences in DFS, but OAS was significantly impaired by the use of FEC-DOC in 0 LN [p=0.024; HR=2.02 (95% CI: 1.10-3.73)] (no ETC use in 0 LN). In case of 1-3 positive LN CMF/FEC/FEC-DOC/ETC did not differ significantly in survival parameters. But in 4-10 LN FEC-DOC [p=0.049; HR=0.67 (95% CI: 0.44-0.99)] and ETC [p=0.024; HR=0.56 (95% CI: 0.34-0.93)] demonstrated a significant benefit in DFS and a strong trend in OAS. Dose-dense ETC showed a significant improvement in DFS [p=0.003; HR=0.35 (95% CI: 0.17-0.69)] and OAS [p=0.009; HR=0.35 (95% CI: 0.16-0.77)] in patients with >10 positive LN. Conclusions: Our data confirms that Taxane-based chemotherapy does not improve DFS in LN negative breast cancer, but rather demonstrated an inferior OAS. But in LN positive breast cancer we can demonstrate a benefit by the use of Taxane-based chemotherapy regimens. Furthermore, dose-dense ETC demonstrated a significant benefit in survival in >10 positive LN.

Analysis of Metastatic Involvement of Interpectoral (Rotter's) Lymph Nodes Related to Tumor Location, Size, Grade and Hormone Receptor Status in Breast Cancer

2005 ◽  
Vol 91 (2) ◽  
pp. 177-181 ◽  
Author(s):  
Danko Velimir Vrdoljak ◽  
Vesna Ramljak ◽  
Dubravka Mužina ◽  
Božena Šarčeviç ◽  
Fabijan Knežević ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Lymph Nodes ◽  
Hormone Receptor ◽  
Serum Levels ◽  
Tumor Location ◽  
Hormone Receptor Status ◽  
Axillary Lymph Nodes ◽  
Axillary Lymph ◽  
Receptor Status ◽  
Metastatic Involvement

Aims and background This study was aimed at analyzing metastatic involvement in interpectoral (Rotter's) lymph nodes in relation to tumor location, size, grade and hormone receptor status in primary breast cancer. Methods The study included 172 female patients undergoing surgery for breast cancer at the University Hospital for Tumors, Zagreb, Croatia from November 2001 to August 2003. In addition to the standard surgical procedure, interpectoral (Rotter's) lymph nodes were removed in all of the patients. Serum levels of the tumor marker CA 15-3 were determined before surgery and hormone receptor status after surgery. Results Rotter's lymph nodes were identified in 67% of the patients, with metastatic involvement being found in 20% of the Rotter's nodes. Metastatic involvement of Rotter's nodes in patients with negative and positive axillary lymph nodes was 4% and 35%, respectively. When we looked at the location of the tumor in patients with metastatic involvement of Rotter's nodes, we found that tumors located in the upper quadrants were more prone to metastasis to Rotter's nodes; there was a significant positive correlation between tumor location and positive Rotter's nodes (r = 0.953, P = 0.012). As regards tumor size, Rotter's nodes were identified in 15%, 20% and 30% of stage T1 (<2 cm), T2 (2-5 cm) and T3 (>5 cm) tumors, respectively. Hormone receptor status showed no statistically significant difference in the expression of estrogen and progesterone receptors between patients with and those without positive Rotter's nodes. Of 35 Rotter's node-positive patients, 31.4% had elevated serum levels of CA 15-3; the level was significantly higher in Rotter's-positive patients compared to those with negative (or absent) Rotter's nodes. Conclusions The results show that one-fifth of breast cancer patients, or even one-third of those with positive axillary lymph nodes, are discharged with positive interpectoral lymph nodes that remain undiagnosed. As the nodes can be surgically removed without additional mutilation, exploration of Rotter's lymph nodes should be introduced into routine clinical practice.

scholarly journals Evaluation of Hormone Receptors Status in Breast Carcinoma

2019 ◽  
Vol 10 (2) ◽  
pp. 70-73
Author(s):  
Kazi Nishat Ara Begum ◽  
Abdul Khaleque Akond ◽  
Naila Huq ◽  
Nazneen Naher Aymon ◽  
Fahmida Huq
Keyword(s):  
Breast Cancer ◽  
Breast Carcinoma ◽  
Lymph Nodes ◽  
Hormone Receptor ◽  
Hormone Receptor Status ◽  
Axillary Lymph Nodes ◽  
Axillary Lymph ◽  
Middle Aged ◽  
Outer Quadrant ◽  
Receptor Status

Background & objective: The importance of establishing hormone receptor status of tumors for the treatment of women with hormone receptor-positive breast cancer is often emphasized. It is critical to evaluate hormone receptor status when considering response to endocrine therapy. The present study was intended to evaluate the usefulness of hormone receptor status in breast carcinoma. Materials & Methods: The present study was conducted in the Department of Pathology, Dhaka Medical College, Dhaka over a period 12 months from July 2009 to June 2010. A total of 30 histopathologically diagnosed cases of breast tumors who were also subjected to immunohistochemical (IHC) test for ER, PR status and HER-2/neu were consecutively included in the study. Patients who have already been treated for malignancy or who had a history of receiving radiotherapy were excluded. Result: Age distributions shows that 40% of the patients were early middle-aged (30-40 years), 30% middle-aged and the rest were either < 30 years or >50 years old. Left breast was involved more often (56.7%) than the right breast (43.3%). The predominant location was upper outer quadrant (43.3%), followed by upper inner quadrant (20%), lower outer quadrant (20%), lower inner quadrant (10%) and central (6.7%). Over half (53.3%) of the tumors were < 5 cm and the rest 5 cm or more. Nearly half (46.7%) of the tumors were moderately differentiated, 36.6% well-differentiated and 16.7% poorly differentiated. In majority (83.3%) of the cases lymph-nodes (axillary lymph nodes) were involved. Based on estrogen and progesterone receptor status, over half (53.3%) of the tumors were ER and PR positive and 40% were Her2/neu overexpressed. Conclusion: The study concluded that half of the Bangladeshi breast cancer patients are ER and PR positive and two in every five cases are Her2/neu overexpressed. J Shaheed Suhrawardy Med Coll, December 2018, Vol.10(2); 70-73

Dose-Dense Adjuvant Chemotherapy with Epirubicin Monotherapy in Patients with Operable Breast Cancer and ≥10 Positive Axillary Lymph Nodes

Oncology ◽  
1998 ◽  
Vol 55 (6) ◽  
pp. 508-512 ◽  
Author(s):  
George Fountzilas ◽  
Costas Nicolaides ◽  
Gerasimos Aravantinos ◽  
Dimosthenis Skarlos ◽  
Paris Kosmidis ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Adjuvant Chemotherapy ◽  
Lymph Nodes ◽  
Operable Breast Cancer ◽  
Axillary Lymph Nodes ◽  
Axillary Lymph ◽  
Dose Dense

scholarly journals An AN OBSERVATIONAL STUDY OF SLN MAPPING IN PATIENTS OF LOCALLY ADVANCED BREAST CANCER FOLLOWING NCT

2020 ◽  
Vol 4 (2) ◽  
Author(s):  
Ankur Garg ◽  
Udbhav Kathpalia ◽  
Shweta Bansal ◽  
Manoj Andley ◽  
Sudipta Saha
Keyword(s):  
Lymph Node ◽  
Sentinel Lymph Node ◽  
Adjuvant Chemotherapy ◽  
Lymph Nodes ◽  
Locally Advanced ◽  
Lymph Node Biopsy ◽  
Axillary Lymph Nodes ◽  
Axillary Lymph ◽  
Node Biopsy ◽  
Neo Adjuvant Chemotherapy

Background : Locally advanced breast carcinoma (LABC) includes a wide range of clinical scenarios- advanced primary tumors (T4), advanced nodal disease and inflammatory carcinomas(1). Traditionally, treatment of LABC included a combination of Chemotherapy, Radiation and Surgery(2). However, there has been a shift to Neoadjuvant Chemotherapy in recent times.(3) Histological status and the number of axillary lymph nodes with metastasis is one of the most important prognostic factors and most powerful predictor of recurrence and survival in patients of breast carcinoma and remains so, even after neo-adjuvant chemotherapy. (3) Information derived from the sentinel lymph node is considered valuable, with less discomfort to the patient when compared with axillary dissection.(4) However, its role in detecting nodal metastasis after neo-adjuvant chemotherapy in LABC is still debatable and definitive studies to evaluate its role are still evolving. (5) Materials and Methods: Patients of LABC were evaluated using ultrasonography (USG) of axilla. Neo-adjuvant chemotherapy (NACT) was administered and patients were reassessed by USG of axilla. Thirty patients with node negative axillary status were subjected to Sentinel lymph node mapping using isosulfan blue followed by Modified Radical Mastectomy and Axillary Lymph Node Dissection. Histopathological evaluation of stained and unstained lymph nodes done and the data, thus obtained, was statistically analysed.   Results: Sentinel lymph node biopsy performed using Isosulfan Blue dye alone, after neo-adjuvant chemotherapy predicts the status of axillary lymph nodes with low accuracy.   Conclusions: Further studies would be required to establish the role of sentinel lymph node biopsy in patients with LABC after NACT.

scholarly journals Assessment of the receptor status in primary breast cancer with synchronous loco regional metastases: prognostic and clinical role?

2019 ◽  
Vol 18 (2) ◽  
pp. 78-82
Author(s):  
O. O. Gordeeva ◽  
L. G. Zhukova ◽  
I. V. Kolyadina ◽  
I. P. Ganshina
Keyword(s):  
Breast Cancer ◽  
Lymph Nodes ◽  
Hormone Receptor ◽  
Primary Breast Cancer ◽  
Locally Advanced ◽  
Metastatic Breast ◽  
Hormone Receptor Status ◽  
Primary Tumors ◽  
Receptor Status ◽  
Regional Metastases

Background. Assessment of hormone receptor status plays a crucial role in treatment of patients with breast cancer. currently, clinicians are limited to determining the expression status of estrogen receptor (ER), progesterone receptor (pR) and HER2 only in primary breast cancer tissues, even in the presence of regional metastases.The purpose of the study was to review available data on heterogeneity of ER, pR and HER2/neu expressions in primary breast cancer and regional metastases.Material and methods. We analyzed publications available from pubmed, medline etc. using the keywords «discordance», «breast cancer», «locally advanced», «regional lymph nodes», «ER», «pR», and «HER2».Results. The clinical and prognostic role in assessing the heterogeneity of the receptor status of primary tumors and synchronous regional metastases, as well as the effect of detected discordance on treatment tactics was assessed.Conclusion. Data on the frequency of discordance in hormone receptor status between primary and metastatic breast cancer tumors and its effect on the further prognosis in breast cancer are still contradictory. However, the fact of the presence of such heterogeneity suggests that some patients with affected lymph nodes will have significant benefits from determining the status of steroid hormones and HER2 not only in the primary tumor, but also in the lymph nodes, since it will open up new opportunities for subsequent targeted therapy.

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