Pathologic tumor size and lymph node status predict for different rates of locoregional recurrence after mastectomy for breast cancer patients treated with neoadjuvant versus adjuvant chemotherapy

Author(s):  
Thomas A Buchholz ◽  
Angela Katz ◽  
Eric A Strom ◽  
Marsha D McNeese ◽  
George H Perkins ◽  
...  
2021 ◽  
Vol 11 ◽  
Author(s):  
Jiahui Huang ◽  
Yiwei Tong ◽  
Xiaosong Chen ◽  
Kunwei Shen

PurposeWith the application of “less extensive surgery” in breast cancer treatment, the pattern of locoregional recurrence (LRR) has significantly changed. This study aims to evaluate the risk and prognostic factors of LRR in a recent large breast cancer cohort.MethodsConsecutive early breast cancer patients who received surgery from January 2009 to March 2018 in Shanghai Ruijin Hospital were retrospectively analyzed. LRR was defined as recurrence at the ipsilateral breast (IBTR), chest wall, or regional lymph nodes and without concurrent distant metastasis (DM). Patients’ characteristics and survival were compared among these groups.ResultsAmong 5,202 patients included, 87 (1.7%) and 265 (5.1%) experienced LRR and DM as first event after a median 47.0 (3.0–122.5) months’ follow-up. LRR was significantly associated with large tumor size and positive lymph node status (p < 0.05). Forty (46.0%) patients received further salvage surgery after LRR and had a significantly better 3-year post-recurrence overall survival than those who did not (94.7% vs. 60.7%, p = 0.012). Multivariate analysis showed that salvage surgery for LRR was independently associated with better survival (HR = 0.12, 95% CI 0.02–0.93, p = 0.043) along with estrogen receptor (ER) positivity (HR = 0.33, 95% CI 0.12–0.91, p = 0.033).ConclusionLRR rate was relatively low in recent era of breast cancer treatment. Tumor size and lymph node status were associated with risk of LRR, and salvage surgery for selected LRR patients achieved an excellent outcome.


2020 ◽  
Author(s):  
Daniel Escuin ◽  
Laura López-Vilaró ◽  
Olga Bell ◽  
Josefina Mora ◽  
Antonio Moral ◽  
...  

Abstract Background: In recent years, miRNAs have emerged as important regulators of many cellular processes, including the various steps of the metastatic process. In addition, circulating miRNAs appear to be surprisingly stable in peripheral blood making them ideal noninvasive biomarkers for disease diagnosis. Here, we investigated the expression profile of circulating miRNAs and their association with the metastatic lymph node status in early breast cancer patients. Methods: We designed a proof-of-principle study using 16 plasma samples from patients with known sentinel lymph node status (n=12 positive and n=4 negative). We performed RNA-sequencing and validated the results by qPCR. Gene Ontology term enrichment and KEGG pathway analyses were carried out using DAVID tools.Results: We found16 differentially expressed miRNAs after adjusting for false discovery correction (q < 0.01) in patients with positive samples. Thirteen miRNAs were down-regulated (miR-339-5p, miR-133a-3p, miR-326, miR-331-3p, miR-369-3p, miR-328-3p, miR-26a-3p, miR-139-3p, miR-493-3p, miR-664a-5p, miR-323b-3pmiR-1307-3p and miR-423-3p) and 3 were up-regulated (miR-101-3p, miR-146a-5p and miR-144-3p). Hierarchical clustering using differentially expressed miRNAs clearly distinguished patients according to their lymph node status. We did not find any difference in the miRNA expression profile between plasma samples associated with macrometastasis or micrometastasis. The expression of 9 miRNAs was validated by qPCR. Moreover, gene ontology analysis showed a significant enrichment of biological processes associated with the regulation of the epithelial mesenchymal transition, cell proliferation and transcriptional regulation. Conclusions: Our results indicated the potential role of several circulating miRNAs as surrogate markers of lymph node metastases in early breast cancer patients. Further validation in a larger cohort of patients will be necessary to confirm our results.


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