scholarly journals Dynamic changes in marital status and survival in women with breast cancer: a population-based study

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Wu Ding ◽  
Guodong Ruan ◽  
Yingli Lin ◽  
Jianming Zhu ◽  
Chuanjian Tu ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Marital Status ◽  
Population Based ◽  
Breast Cancer Patients ◽  
Single Group ◽  
Dynamic Changes ◽  
Eligibility Criteria ◽  
Cox Proportional Hazard ◽  
Cox Proportional Hazard Regression ◽  
The Impact

AbstractMarital status proved to be an independent prognostic factor for survival in patients with breast cancer. We therefore strove to explore the impact of dynamic changes in marital status on the prognosis of breast cancer patients. We selected patients meeting the eligibility criteria from the Surveillance, Epidemiology, and End Results cancer database. We then used multivariate Cox proportional hazard regression model to analyze the effect of dynamic changes in marital status on the prognosis of overall survival (OS) and breast cancer-specific special survival (BCSS). Compared with the patients in the Single–Single group and the divorced/separated/widowed–divorced/separated/widowed (DSW–DSW) group, patients in the Married–Married group were significantly associated with better BCSS (HR 1.13, 95% CI: 1.03–1.19, P < 0.001; HR 1.19, 95% CI: 1.14–1.25, P < 0.001, respectively) and OS (HR 1.25, 95% CI: 1.20–1.30, P < 0.001; HR 1.49, 95% CI: 1.45–1.54, P < 0.001, respectively). In contrast to the DSW–DSW group, the Single–Single group and the DSW–Married group showed similar BCSS (HR 0.98, 95% CI: 0.92–1.05, P = 0.660; HR 1.06, 95% CI: 0.97–1.15, P = 0.193, respectively) but better OS (HR 1.14, 95% CI: 1.09–1.19, P < 0.001; HR 1.32, 95% CI: 1.25–1.40, P < 0.001, respectively). Compared with the Single–Single group, the Single–Married group showed significantly better BCSS (HR 1.21, 95% CI: 1.07–1.36, P = 0.003) but no difference in OS (HR 1.08, 95% CI: 0.98–1.18, P = 0.102); In contrast to the Married–DSW group, the Married–Married group exhibited better BCSS (HR 1.11, 95% CI: 1.05–1.18, P < 0.001) and OS (HR 1.27, 95% CI: 1.22–1.32, P < 0.001). Our study demonstrated that, regardless of their previous marital status, married patients had a better prognosis than unmarried patients. Moreover, single patients obtained better survival outcomes than DSW patients. Therefore, it is necessary to proactively provide single and DSW individuals with appropriate social and psychological support that would benefit them.

scholarly journals Computer-assisted quantification of tumor-associated collagen signatures to improve the prognosis prediction of breast cancer

BMC Medicine ◽  
2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Gangqin Xi ◽  
Lida Qiu ◽  
Shuoyu Xu ◽  
Wenhui Guo ◽  
Fangmeng Fu ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Regression Analysis ◽  
Cancer Patients ◽  
Validation Cohort ◽  
Proportional Hazard ◽  
Breast Cancer Patients ◽  
Cox Proportional Hazard ◽  
Clinical Center ◽  
Microscopic Features ◽  
Cox Proportional Hazard Regression

Abstract Background Collagen fibers play an important role in tumor initiation, progression, and invasion. Our previous research has already shown that large-scale tumor-associated collagen signatures (TACS) are powerful prognostic biomarkers independent of clinicopathological factors in invasive breast cancer. However, they are observed on a macroscale and are more suitable for identifying high-risk patients. It is necessary to investigate the effect of the corresponding microscopic features of TACS so as to more accurately and comprehensively predict the prognosis of breast cancer patients. Methods In this retrospective and multicenter study, we included 942 invasive breast cancer patients in both a training cohort (n = 355) and an internal validation cohort (n = 334) from one clinical center and in an external validation cohort (n = 253) from a different clinical center. TACS corresponding microscopic features (TCMFs) were firstly extracted from multiphoton images for each patient, and then least absolute shrinkage and selection operator (LASSO) regression was applied to select the most robust features to build a TCMF-score. Finally, the Cox proportional hazard regression analysis was used to evaluate the association of TCMF-score with disease-free survival (DFS). Results TCMF-score is significantly associated with DFS in univariate Cox proportional hazard regression analysis. After adjusting for clinical variables by multivariate Cox regression analysis, the TCMF-score remains an independent prognostic indicator. Remarkably, the TCMF model performs better than the clinical (CLI) model in the three cohorts and is particularly outstanding in the ER-positive and lower-risk subgroups. By contrast, the TACS model is more suitable for the ER-negative and higher-risk subgroups. When the TACS and TCMF are combined, they could complement each other and perform well in all patients. As expected, the full model (CLI+TCMF+TACS) achieves the best performance (AUC 0.905, [0.873–0.938]; 0.896, [0.860–0.931]; 0.882, [0.840–0.925] in the three cohorts). Conclusion These results demonstrate that the TCMF-score is an independent prognostic factor for breast cancer, and the increased prognostic performance (TCMF+TACS-score) may help us develop more appropriate treatment protocols.

Sentinel lymph node biopsy is associated with a significantly improved survival compared to level Iand II axillary lymph node dissection in node-negative breast cancer patients

2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 609-609
Author(s):  
I. Langer ◽  
U. Guller ◽  
S. Hsu Schmitz ◽  
A. Ladewig ◽  
C. T. Viehl ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Overall Survival ◽  
Lymph Node ◽  
Early Stage ◽  
Axillary Lymph ◽  
Breast Cancer Patients ◽  
Node Negative ◽  
Cox Proportional Hazard ◽  
Cox Proportional Hazard Regression ◽  
Disease Free

609 Background: The sentinel lymph node (SLN) biopsy has emerged as the standard of care in evaluating the axillary lymph node status in early stage breast cancer patients. It is well known that step sectioning and immunohistochemistry of the SLN allow for a more accurate histopathologic examination. Conversely, it remains to be elucidated whether or not the more accurate SLN staging is associated with improved survival. Therefore, the objective of the present investigation was to evaluate if patients undergoing a SLN biopsy have an improved disease-free and overall survival compared to those undergoing ALND. Methods: From our prospective database 355 node negative patients with early stage breast cancer (pT1 und pT2 <=3cm, pN0/pNSN0) were assessed. Patients underwent either ALND (n=178) in the years 1990–1997 or a SLN biopsy (n=177) in 1998–2004. Long-term disease-free and overall survival were analysed for both groups. Log-rank tests were used for unadjusted analyses, a Cox proportional hazard regression model for risk-adjusted analyses. Results: The median follow- up was 48.2 months in the SLN group and 120.0 months in the ALND group. Patients in the SLN group had a significantly better disease-free (p=0.012) and overall survival (p=0.04) compared to the ALND group. In Cox proportional hazard regression analysis, the performed procedure (SLN compared to ALND) was an independent predictor for improved disease-free survival (hazard ratio 0.28, 95% confidence interval 0.11–0.75, p=0.011) and overall survival (hazard ratio 0.36, 95% confidence interval 0.14–0.89, p=0.027). Conclusion: The present analysis - the first one in the literature - provides compelling evidence that patients with a negative SLN have a significantly improved disease-free and overall survival compared to node negative patients undergoing ALND. This relevant finding is most likely due to an improved histopathologic staging accuracy. The significant survival benefit of node negative patients having SLN biopsy highlights yet another important advantage of the SLN concept in breast cancer. No significant financial relationships to disclose.

Impact of sequence order of anthracyclines and taxanes in neoadjuvant chemotherapy for breast cancer: Results from a prospective institutional database.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. e12619-e12619
Author(s):  
Megan Tesch ◽  
Nathalie LeVasseur ◽  
Christine E. Simmons ◽  
Stephen K. L. Chia
Keyword(s):  
Breast Cancer ◽  
Neoadjuvant Chemotherapy ◽  
Triple Negative ◽  
Pathologic Complete Response ◽  
Complete Response ◽  
Breast Conserving Surgery ◽  
Breast Cancer Patients ◽  
Duration Of Treatment ◽  
Eligibility Criteria ◽  
The Impact

e12619 Background: There has been growing interest in the optimal sequencing of anthracyclines and taxanes in neoadjuvant chemotherapy (NACT) for breast cancer. However, data comparing efficacy of administering taxanes prior to anthracyclines as opposed to the opposite sequence remains limited and inconsistent. The objective of our study was to assess the impact of sequence order on pathologic and clinical outcomes in a real-world setting. Methods: A prospective institutional database was analyzed to identify all HER2-negative breast cancer patients treated with NACT from 2012 to 2019. Rates of pathologic complete response (pCR), down-staging, and breast-conserving surgery were compared between patients who received anthracyclines followed by taxanes (AC-T) to those who received taxanes followed by anthracyclines (T-AC). Chi-square and independent sample non-parametric tests were used to test for associations between variables and outcomes. Results: Of the 270 patients who met eligibility criteria, 175 (65%) received AC-T and 95 (35%) received T-AC. Median age was 55 (IQR 24-86). Overall, 83% of patients had stage IIB or greater tumors, 40% had grade 3 histology, and 36% had triple-negative disease. Characteristics were balanced between the AC-T and T-AC groups (all p < 0.05). Median duration of treatment with NACT was 102 days (IQR 29-203). Rates of pCR (19% vs 21%, p = 0.750), down-staging (68% vs 61%, p = 0.188), and conversion to breast-conserving surgery (26% vs 20%, p = 0.314) were similar for AC-T vs T-AC, respectively. pCR was higher in triple-negative compared to hormone-positive cases (33% vs 13%, p < 0.001). Conclusions: In this small population-based cohort, sequence order of anthracyclines and taxanes did not demonstrate statistically significant differences in evaluated outcomes from NACT for breast cancer. This supports the current variation in prescribing practice and highlights the need for further studies in this area.

scholarly journals Metachronous Contralateral Testicular Cancer in the Cisplatin Era: A Population-Based Cohort Study

2020 ◽  
pp. JCO.20.02713
Author(s):  
Ragnhild Hellesnes ◽  
Tor Åge Myklebust ◽  
Roy M. Bremnes ◽  
Ása Karlsdottir ◽  
Øivind Kvammen ◽  
...  
Keyword(s):  
Testicular Cancer ◽  
Population Based ◽  
Treatment Intensity ◽  
Male Population ◽  
Cox Proportional Hazard ◽  
General Male Population ◽  
Treatment Data ◽  
Effect Of Treatment ◽  
Cox Proportional Hazard Regression ◽  
The Impact

PURPOSE It is hypothesized that cisplatin-based chemotherapy (CBCT) reduces the occurrence of metachronous contralateral (second) germ cell testicular cancer (TC). However, studies including treatment details are lacking. The aim of this study was to assess the second TC risk, emphasizing the impact of previous TC treatment. PATIENTS AND METHODS Based on the Cancer Registry of Norway, 5,620 men were diagnosed with first TC between 1980 and 2009. Treatment data regarding TC were retrieved from medical records. Cumulative incidences of second TC were estimated, and standardized incidence ratios were calculated. The effect of treatment intensity was investigated using Cox proportional hazard regression. RESULTS Median follow-up was 18.0 years, during which 218 men were diagnosed with a second TC after median 6.2 years. Overall, the 20-year crude cumulative incidence was 4.0% (95% CI, 3.5 to 4.6), with lower incidence after chemotherapy (CT) (3.2%; 95% CI, 2.5 to 4.0) than after surgery only (5.4%; 95% CI, 4.2 to 6.8). The second TC incidence was also lower for those age ≥ 30 years (2.8%; 95% CI, 2.3 to 3.4) at first TC diagnosis than those age < 30 years (6.0%; 95% CI, 5.0 to 7.1). Overall, the second TC risk was 13-fold higher compared with the risk of developing TC in the general male population (standardized incidence ratio, 13.1; 95% CI, 11.5 to 15.0). With surgery only as reference, treatment with CT significantly reduced the second TC risk (hazard ratio [HR], 0.55). For each additional CBCT cycle administered, the second TC risk decreased significantly after three, four, and more than four cycles (HRs, 0.53, 0.41, and 0.21, respectively). CONCLUSION Age at first TC diagnosis and treatment intensity influenced the second TC risk, with significantly reduced risks after more than two CBCT cycles.

Persistence of circulating tumour cells after treatment predicts clinical outcome in breast cancer patients

2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 21080-21080
Author(s):  
M. Serrano ◽  
P. Sánchez-Rovira ◽  
M. Campos ◽  
F. Warleta ◽  
J. Ruiz-Mora ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Regression Analysis ◽  
Clinical Outcome ◽  
Cancer Patients ◽  
Tumor Cells ◽  
Circulating Tumor Cells ◽  
Proportional Hazard ◽  
Breast Cancer Patients ◽  
Cox Proportional Hazard ◽  
Cox Proportional Hazard Regression

21080 Background: The hematogenous distant metastasis is the leading cause of cancer death. This process involves the passage through the blood and lymphatic circulation of circulating tumor cells (CTC) with metastatic properties. Thus, the early detection of such cells has important implication for cancer prognosis, monitoring of treatment and to predict clinical outcome. We present the results that showed that CTC are prognostic factor after chemotherapy independently of treatment. Methods: A total of 59 patients with breast cancer were enrolled in this study between April 2000 and December 2002. The median follow-up was 50 months. All patients received chemotherapy as first line treatment. Results of this work included CTC detection one month after of the end of chemotherapy. After informed consent, 10ml of heparinized peripheral blood was collected from patients. For enrichment of CTC we use the Carcinoma Cell Enrichment and Detection kit using MACS technology (Miltenyi Biotec). After enrichment of epithelial tumor cells immunomagnetic labeled with a multi- cytokeratin-specific antibody, the positive cells were detected by immunocytochemical staining with alkaline phosphatase substrate. Results: Analysis of CTC after chemotherapy: Circulating tumor cells were detected in 32 patients (54.23%). A mean number of cells were detected 3.7 (SD 13.9; range 1–105).The number of CTC was correlationed with progression free of disease (PFS) and overall survival (OS). In the univariate Cox proportional hazard regression analysis number cells were significantly associated with OS (p = 0.020) and PFS (p = 0.008). In the multivariate Cox proportional hazard regression analysis, number cells admit borderline statically significance with PFS (p = 0.052) and OS (p = 0.071). Conclusions: Our results suggest that the persistence of CTC after the treatment predicts clinical outcome and therefore the detection of CTC in breast cancer patients might allow monitoring of chemotherapy response. No significant financial relationships to disclose.

The impact of residual cancer removed during subsequent surgeries on the outcome of patients with localized breast cancer

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. e11533-e11533
Author(s):  
N. B. Kouzminova ◽  
A. Aggarwal ◽  
S. Aggarwal ◽  
A. Y. Lin
Keyword(s):  
Breast Cancer ◽  
Positive Margin ◽  
Distant Recurrence ◽  
Breast Cancer Surgery ◽  
Breast Cancer Patients ◽  
Residual Cancer ◽  
Single Procedure ◽  
Second Surgery ◽  
Cox Proportional Hazard Regression ◽  
The Impact

e11533 Background: A close or positive margin after breast cancer surgery is an important risk factor for local recurrence. A significant percentage of breast cancer patients need additional surgeries to obtain clear margins. This study evaluated the impact of residual cancer (RC) found upon subsequent operations on the outcome of the patients with localized breast cancer. Methods: Under IRB approved protocol, we retrospectively analyzed data on 573 patients with stage I-IIIA breast cancer treated at our institution during 1994–2004. 202 patients had complete tumor removal at single procedure with clear margins, 319 patients had subsequent surgery due to initially compromised margins and 52 patients with compromised margins did not have second surgery. Cox Proportional Hazard regression test was performed to evaluate the effect of RC found on subsequent surgery on distant recurrence (DR) and disease specific survival (DSS). Results: Median follow-up was 5.4 years. Among 319 patients who underwent second surgery, 57.7% did not have any RC; 13.1% had in situ RC and 29.2% had invasive RC. 12.9% (74/573) patients had DR. The risk of DR was higher in patients with RC found upon second surgery compared to those who had single procedure breast cancer removal (22.6% vs. 9.9%; HR 2.4, 95% CI 1.3–4.4, p=0.006). Similarly, finding of RC was a significant predictor of DSS (80.6% vs.92.6%; HR 2.9, 95% CI 1.4–5.7, p=0.003). Multivariate analysis revealed that tumor size above 5 cm, lymph nodes involvement and grade III were significant predictors of DR and DSS along with invasive RC found during subsequent surgeries. Delay in adjuvant chemotherapy due to need for subsequent surgeries strongly correlated with earlier DR in patients with invasive RC found on subsequent operations (rS = - 0.55, p = 0.019, two-tailed). Conclusions: Invasive residual carcinoma found during subsequent surgery after initial compromised margin is an important prognostic factor for DR and DSS, even after clear margins are eventually achieved. No significant financial relationships to disclose.

scholarly journals The impact of different preanalytical methods related to CA 15-3 determination in frozen human blood samples: a systematic review

2021 ◽  
Vol 10 (1) ◽  
Author(s):  
Luigi Coppola ◽  
Alessandra Cianflone ◽  
Katia Pane ◽  
Monica Franzese ◽  
Peppino Mirabelli ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Medical Diagnostics ◽  
Cochrane Library ◽  
Bibliographic Databases ◽  
Breast Cancer Patients ◽  
Sample Storage ◽  
Qualitative Synthesis ◽  
Eligibility Criteria ◽  
Scientific Papers ◽  
The Impact

Abstract Background The determination of CA 15-3 is useful for monitoring breast cancer patients. Several retrospective studies determined CA 15-3 levels in frozen samples to evaluate the sensitivity and specificity of novel biomarkers in relation to breast cancer; however, freeze-thaw cycles, as well as preanalytical variables before sample storage, are not always reported. Here, we analyzed the current scientific literature to identify possible critical aspects related to CA 15-3 determination in frozen-stored human serum/plasma samples. Methods We obtained data from 4 different bibliographic databases: Web of Science, Embase, PubMed, and Cochrane Library. We followed the PRISMA guidelines to screen and select the eligible articles discussed in the final revision. Results Initially, 674 scientific papers were evaluated, and after the application of the screening and eligibility criteria, 18 studies were included in the qualitative synthesis. The analysis reported an important level of heterogeneity concerning the preanalytical phase before sample storage. Conclusion Although advances in healthcare have been achieved using certified workflows in medical diagnostics, standardized preanalytical processes are not always applied when referring to frozen-stored biosamples. Biobanks will guarantee the best possible conditions for the storage of human biological samples to be used in clinical research. The use of certified bioresources will favor the optimal development and introduction of new disease biomarkers.

Breast cancer screening: Biology of tumors detected by analog and digital mammography.

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. 587-587
Author(s):  
Caroline Drukker ◽  
Marjanka Schmidt ◽  
Emiel J. Rutgers ◽  
Fatima Cardoso ◽  
Karla Kerlikowske ◽  
...  
Keyword(s):  
Breast Cancer ◽  
High Risk ◽  
Digital Mammography ◽  
Screening Program ◽  
Gene Signature ◽  
Population Based ◽  
Low Risk ◽  
Breast Cancer Patients ◽  
Background Population ◽  
The Impact

587 Background: Population-based screening might be associated with a higher likelihood of a (ultra)low risk tumor assessed by the 70-gene signature (MammaPrint) (ultralow defined as indexscore >0.6, no distant metastasis observed at 5 years in the original 78 patients). The aim of this study is to determine the proportion of biologically (ultra)low risk tumors among the screen-detected tumors and to evaluate the impact of the analog versus digital screening technique. Methods: All Dutch breast cancer patients enrolled in the MINDACT trial (EORTC-10041), who were invited for the Dutch screening program (biennial, age 50-75), were included (n=1409). The proportions of 70-gene signature high, low and ultralow risk were calculated for patients with screen-detected (n=775), interval (n=390), and symptomatic, non-screening (n=244) carcinomas, taking into account analog vs. digital technology. Co-variants such as age, tumor size, grade, histological type, ER, HER2 and nodal status were included in the analyses. Results: Among the screen-detected tumors, 31.5% had a high risk, 31.2% a low risk and 37.3% an ultralow risk 70-gene signature result, compared to 47.4%, 28.5% and 24.1% among the interval carcinomas, respectively (p=0.001). Among the screen-detected carcinomas, 40.6% were detected using analog (n=315) and 59.4% using digital mammography (n=459). When using digital imaging a shift was seen among the screen-detected tumors in the proportions of high risk tumors from 27% to 35% and ultralow risk from 42% to 34%, low risk proportions remained the same (31%)(p=0.011). No such difference was seen for other tumor characteristics. Conclusions: Screen-detection was found to be associated with a higher likelihood of a biologically low risk tumor. The transition from analog to digital mammography resulted in a smaller proportion of ultralow risk and a larger proportion of high risk tumors among the screen-detected carcinomas.

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