Impact of staging computerised tomography scan in the management of loco-regional recurrence of breast cancer

Abstract Background The number of young patients diagnosed with breast cancer is on the rise. We studied the rate trend of local recurrence (LR) and regional recurrence (RR) in young breast cancer (YBC) patients and outcomes among these patients based on molecular subtypes. Methods A retrospective cohort study was conducted based on data from Tianjin Medical University Cancer Institute and Hospital for patients ≤ 35 years of age with pathologically confirmed primary invasive breast cancer surgically treated between 2006 and 2014. Patients were categorized according to molecular subtypes on the basis of hormone receptor (HR) and human epidermal growth factor receptor 2 (HER2) status. The 5-year rates for LR, RR, and distant metastases (DM) were estimated by Kaplan-Meir statistics. Nelson-Aalen cumulative-hazard plots were used to describe local recurrence- and distant metastasis-free intervals. Results We identified 25,284 patients with a median follow-up of 82 months, of whom 1099 (4.3%) were YBC patients ≤ 35 years of age. The overall 5-year LR, RR, and DM rates in YBC patients were 6.7%, 5.1%, and 16.6%, respectively. The LR and RR rates demonstrated a decreasing trend over time (P = 0.028 and P = 0.015, respectively). We found that early-stage breast cancer and less lymph node metastases increased over time (P = 0.004 and P = 0.007, respectively). Patients with HR−/HER2+ status had a significantly higher LR (HR 20.4; 95% CI, 11.8–35.4) and DM (HR 37.2; 95% CI, 24.6–56.3) at 10 years. Breast-conserving surgery (BCS) or mastectomy did not influence rates of LR and RR. In the overall population, the 5-year survival of YBC patients exceeded 90%. Conclusions The rates of LR and RR with YBC patients demonstrated a downward trend and the proportion of early-stage breast cancer increased between 2006 and 2014. We report the highest LR rates in this young population were associated with HR−/HER2+ tumors.

Download Full-text

Prognostic index score and clinical prediction model of local regional recurrence after mastectomy in breast cancer patients

International Journal of Radiation Oncology*Biology*Physics ◽

10.1016/j.ijrobp.2005.11.015 ◽

2006 ◽

Vol 64 (5) ◽

pp. 1401-1409 ◽

Cited By ~ 44

Author(s):

Skye Hongiun Cheng ◽

Cheng-Fang Horng ◽

Jennifer L. Clarke ◽

Mei-Hua Tsou ◽

Stella Y. Tsai ◽

...

Keyword(s):

Breast Cancer ◽

Prediction Model ◽

Cancer Patients ◽

Prognostic Index ◽

Index Score ◽

Regional Recurrence ◽

Clinical Prediction ◽

Breast Cancer Patients ◽

Clinical Prediction Model ◽

Local Regional Recurrence

Download Full-text

Computerised tomography scan in multi-drug-resistant versus extensively drug-resistant tuberculosis

Polish Journal of Radiology ◽

10.5114/pjr.2020.93123 ◽

2020 ◽

Vol 85 (1) ◽

pp. 39-44 ◽

Cited By ~ 2

Author(s):

Payam Mehrian ◽

Poopak Farnia ◽

Dina Jalalvand ◽

Mostafa Chamani ◽

Mahmood Bakhtiyari

Keyword(s):

Drug Resistant ◽

Computerised Tomography ◽

Drug Resistant Tuberculosis ◽

Resistant Tuberculosis ◽

Extensively Drug Resistant ◽

Tomography Scan

Download Full-text

Direct traumatic optic neuropathy in a temporal laceration: A case report

Trauma ◽

10.1177/1460408615624726 ◽

2016 ◽

Vol 19 (1) ◽

pp. 66-68

Author(s):

Simon WJ Grant ◽

Moorthy Halsnad ◽

Steve Colley ◽

Ian Sharp

Keyword(s):

Optic Neuropathy ◽

Penetrating Trauma ◽

Temporal Region ◽

Computerised Tomography ◽

Traumatic Optic Neuropathy ◽

Maxillofacial Region ◽

Case Presentation ◽

Orbital Wall ◽

The Right ◽

Tomography Scan

Facial lacerations are a common presentation in emergency departments. It is important to appreciate the mechanism of injury and the anatomy of structures involved in penetrating lacerations in the maxillofacial region. A 65-year-old man suffered an accidental penetrating injury with a sharp kitchen knife to the right temporal region. There was a single laceration to the right temporal region. The right eye had no perception to light, a total afferent and efferent pupillary defect and partial ophthalmoplegia. Computerised tomography scan revealed signs of penetration through the skin, temporalis, postero-lateral orbital wall and orbital apex. There was no injury to the globe or either retrobulbar or intracranial haemorrhage. A diagnosis of direct traumatic optic neuropathy was made following consultation with opthalmology and neurosurgery teams. Only two similar cases of penetrating trauma in the temporal region resulting in direct traumatic optic neuropathy have been identified in the literature. This case presentation highlights the structures that are at risk of damage from penetrating trauma in the maxillofacial region.

Download Full-text

Anti-apoptotic phenotype is associated with decreased loco-regional recurrence rate in breast cancer

European Journal of Cancer ◽

10.1016/s0959-8049(98)80408-5 ◽

1998 ◽

Vol 34 ◽

pp. S99-S100

Author(s):

J.J. Jager ◽

R.L.H. Jansen ◽

J.W. Arends ◽

S. Joosten-Achjanie ◽

L. Volovics ◽

...

Keyword(s):

Breast Cancer ◽

Recurrence Rate ◽

Regional Recurrence

Download Full-text

A pilot study to investigate the role of the 26S proteasome in radiotherapy resistance and loco-regional recurrence following breast conserving therapy for early breast cancer

The Breast ◽

10.1016/j.breast.2011.02.017 ◽

2011 ◽

Vol 20 (4) ◽

pp. 334-337 ◽

Cited By ~ 12

Author(s):

Dalia ELFadl ◽

Victoria C. Hodgkinson ◽

Ervine D. Long ◽

Lucy Scaife ◽

Philip J. Drew ◽

...

Keyword(s):

Breast Cancer ◽

Pilot Study ◽

Early Breast Cancer ◽

Breast Conserving Therapy ◽

26S Proteasome ◽

Regional Recurrence ◽

Radiotherapy Resistance

Download Full-text

Predictors of Local-Regional Recurrence After Neoadjuvant Chemotherapy and Mastectomy Without Radiation

Journal of Clinical Oncology ◽

10.1200/jco.2002.20.1.17 ◽

2002 ◽

Vol 20 (1) ◽

pp. 17-23 ◽

Cited By ~ 65

Author(s):

Thomas A. Buchholz ◽

Susan L. Tucker ◽

Lawrence Masullo ◽

Henry M. Kuerer ◽

Jessica Erwin ◽

...

Keyword(s):

Breast Cancer ◽

Neoadjuvant Chemotherapy ◽

Lymph Nodes ◽

Primary Tumor ◽

Clinical Stage ◽

Pathologic Complete Response ◽

Hazard Ratio ◽

Regional Recurrence ◽

Postmastectomy Radiation ◽

Local Regional Recurrence

PURPOSE: To define clinical and pathologic predictors of local-regional recurrence (LRR) for patients treated with neoadjuvant chemotherapy and mastectomy without radiation. PATIENTS AND METHODS: We analyzed the outcome of the 150 breast cancer cases treated on prospective institutional trials with neoadjuvant chemotherapy and mastectomy without postmastectomy radiation. Clinical stage at diagnosis was I in 1%, II in 43%, IIIA in 23%, IIIB in 25%, and IV in 7%. No patient had inflammatory breast cancer. RESULTS: The median follow-up period of surviving patients was 4.1 years. The 5- and 10-year actuarial rates of LRR were both 27%. Pretreatment factors that positively correlated with LRR were increasing T stage (P < .0001) and increasing combined clinical stage (P < .0001). Pathologic and treatment factors that positively correlated with LRR were size of the residual primary tumor (P = .0048), increasing number of involved lymph nodes (P < .0001), and no use of tamoxifen (P = .0013). The LRR rate for the 18 patients with a pathologic complete response of both the primary tumor and lymph nodes (pCR) was 19% (95% confidence interval, 6% to 48%). In a forward stepwise Cox logistic regression analysis, clinical stage IIIB or greater (hazard ratio of 4.5, P < .001), pathologic involvement of four or more lymph nodes (hazard ratio of 2.7, P = .008), and no use of tamoxifen (hazard ratio of 3.9, P = .027) independently predicted for LRR. CONCLUSION: Advanced disease at presentation and positive lymph nodes after chemotherapy predict for clinically significant rates of LRR. Achievement of pCR does not preclude the need for postmastectomy radiation if warranted by the pretreatment stage of the disease.

Download Full-text