Adjuvant therapy and long-term outcomes in older women with early breast cancer: A single institution experience

Purpose: Increasing numbers of older women are affected by early breast cancer, because of prolonged life expectancy and the increasing incidence of breast cancer with age. The role of adjuvant therapy for this population is still a matter of debate. We reviewed the long-term outcome of a mature trial comparing endocrine treatment versus no adjuvant therapy in older women with node-positive breast cancer. Patients and Methods: From 1978 to 1981, 349 women 66 to 80 years of age with pathologically involved lymph nodes after total mastectomy and axillary clearance were randomly assigned to receive 12 months of adjuvant tamoxifen plus low-dose prednisone (p+T) or no adjuvant therapy. Three hundred twenty patients were eligible. Results: At 21 years’ median follow-up, 1 year of p+T significantly prolonged disease-free survival (DFS; P = .003) and overall survival (P = .05; 15-year DFS, 10% ± 3% v 19% ± 3%; hazard ratio, 0.71; 95% CI, 0.58 to 0.86). When comparing competing causes of failure (breast cancer recurrence and deaths before breast cancer recurrence), p+T was far superior in controlling breast cancer recurrence (P = .0003), but the improvement was seen mainly in soft tissue sites. Conversely, patients in the p+T group were more likely to die before a breast cancer recurrence (P = .03). Conclusion: This trial demonstrates that significant treatment benefits continue to be observed in older patients treated for 1 year with p+T. Despite issues relating to competing causes of failure, older breast cancer patients can benefit from treatment and should be considered for trials of adjuvant systemic therapy.

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Long-term Outcomes of Pregnancy-Associated Breast Cancer: A Single Institution Experience

Liaquat National Journal of Cancer Care ◽

10.37184/lnjcc.2789-0112.2.2 ◽

2021 ◽

Keyword(s):

Breast Cancer ◽

Triple Negative ◽

Long Term Outcomes ◽

Single Institution ◽

Term Survival ◽

Long Term Survival ◽

Response To Chemotherapy ◽

Her 2

Background: The incidence of pregnancy-associated breast cancer (PABC) is increasing, especially in the developed countries. Herein, we report the long-term outcomes of PABC from a single institution in an Arab country. Methods: Consecutive patients diagnosed to have PABC between 2005 and 2012 at a tertiary referral hospital from a Gulf cooperation council country were the subjects of the study. Long-term outcomes are reported, with a minimum follow-up of 8 years. Results: A total of 16 patients were evaluable for long-term survival analysis. The median age at the time of diagnosis was 31.5 (26-40) years. Nine (56%) patients were multiparous (> 5 previous pregnancies). The mean gestational age at diagnosis was 19.7±7.4 weeks. Immunohistochemistry revealed the following phenotypes: Luminal A 3 (18.8%); HER-2 enriched 8 (50%); triple-negative 5 (31.2%). Three patients underwent modified radical mastectomy as the initial treatment, of which 2 received adjuvant chemotherapy during pregnancy. For patients who received neoadjuvant or palliative chemotherapy, the response rate was 75% (pCR 2; CR 1; PR 6). After a median follow-up of 60 months, median progression-free survival was 36 months (95%CI 24.2 to 47.8), while the overall survival was 59 months (95%CI 31.6 – 86.4). Age, marker status, Ki-67 score, clinical stage and differentiation grade did not affect the PFS or OS on univariate analysis. Conclusions: Fifty percent of the patient with PABC expressed HER-2/neu protein, and 1/3rd had triple-negative disease. The rate of response to chemotherapy, and long-term survival may help to set a benchmark for studies from the region. Larger cohort studies may help to draw firm conclusions.

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Hypothesis: Breast Cancer as a Possible Complication of Some Types of COVID.19 Vaccines

Journal of Infectious Diseases & Case Reports ◽

10.47363/jidscr/2021(2)145 ◽

2021 ◽

pp. 1-1

Author(s):

Mosab Nouraldein Mohammed Hamad ◽

Keyword(s):

Breast Cancer ◽

Clinical Trials ◽

Older Women ◽

Long Term Outcomes ◽

Short Term ◽

Exogenous Estrogen

Quick development of COVID.19 vaccines, trigger a big question about validity of clinical trials conducted on it. We observed several short-term consequences of this artificial method of immunization, but no one knows the long-term outcomes of it, I regarded that exogenous estrogen constituent of it as probable cause of breast cancer, specifically among older women.

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Differences in baseline risk estimated by physicians and patients with early breast cancer

Japanese Journal of Clinical Oncology ◽

10.1093/jjco/hyab152 ◽

2021 ◽

Author(s):

Makiko Mori ◽

Akiyo Yoshimura ◽

Masataka Sawaki ◽

Masaya Hattori ◽

Haruru Kotani ◽

...

Keyword(s):

Breast Cancer ◽

Adjuvant Therapy ◽

Early Breast Cancer ◽

Baseline Risk ◽

Breast Cancer Patients ◽

Single Institution ◽

Patient Factors ◽

Lower Baseline ◽

Number Of Patients ◽

Secondary Endpoints

Abstract Background Physicians recommend adjuvant therapy to patients based on baseline risk. A common recognition for baseline risk between patients and physicians is critical for successful adjuvant therapy. We prospectively investigated the differences in estimated baseline risk between physicians and patients with early breast cancer. Methods This analysis was performed at a single institution in Japan. Early breast cancer patients over 18 years old were enrolled after surgery. After explaining the pathological results, physicians asked each patient about an estimated baseline risk. Differences in estimated baseline risk were defined as the baseline risk estimated by patients minus the baseline risk estimated by physicians. The primary endpoint was that the number of patients who estimate baseline risk higher than physicians was higher than those who estimate a lower baseline risk. The secondary endpoints were differences in estimated baseline risk by stage, subtype and the influence of patient factors to differences in estimated baseline risk. Results From July 2017 to December 2018, 262 patients were enrolled. Among the 262 patients, 190 estimated a higher baseline risk than physicians, 53 estimated a lower baseline risk and 19 estimated the same. Overall, patients estimated a significantly higher baseline risk than physicians (P < 0.001). Differences in estimated baseline risk was significantly smaller in patients who knew the term ‘baseline risk’ than patients who did not (P = 0.0037). Differences in estimated baseline risk were also significantly smaller in patients with stage II breast cancer than patients with stage I (P = 0.0239). However, there were no statistically significant differences of differences in estimated baseline risk according to other factors. Conclusions Patients with early breast cancer estimated a significantly higher baseline risk than physicians. Physicians should accurately explain baseline risk to patients for shared decision making.

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