Estimation and external validation of a new prognostic model for predicting recurrence-free survival for early breast cancer patients in the UK

Abstract PurposeEstrogen receptor (ER) expression in breast cancer plays an essential role in carcinogenesis and disease progression. Recently, tumors with low level (1-10%) of ER expression have been separately defined as ER Low Positive (ERlow). It is suggested that ERlow tumors might be morphologically and behaviorally different from tumors with high ER expression (ERhigh).MethodsRetrospective analysis of a prospective cohort database was performed. Patients who underwent curative surgery for early breast cancer and had available medical records were included for analysis. Difference in clinicopathological characteristics, endocrine responsiveness and five-year recurrence-free survival was evaluated between different ER subgroups (ERhigh, ERlow, and ER-negative (ER-)).ResultsA total of 2162 breast cancer patients were included in the analysis, Tis and T1 stage. Among them, 1654 (76.5%) were ERhigh, 54 (2.5%) were ERlow, and 454 (21.0%) were ER- patients. ERlow cases were associated with smaller size, higher histologic grade, positive human epidermal growth factor receptor 2 (HER2), negative progesterone receptor, and higher Ki-67 expression. Recurrence rate was highest in ER- tumors and was inversely proportional to ER expression. Recurrence-free survival was not affected by hormonal therapy in the ERlow group (P = 0.418).ConclusionERlow breast cancer showed distinct clinicopathological features. ERlow tumors seemed to have higher recurrence rates compared to ERhigh tumors, and they showed no significant benefit from hormonal therapy. Future large scale prospective studies are necessary to validate the treatment options for ERlow breast cancer.

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Chemotherapy-induced amenorrhea: Influence on disease-free survival and overall survival in receptor positive premenopausal early breast cancer patients

Journal of Clinical Oncology ◽

10.1200/jco.2005.23.16_suppl.850 ◽

2005 ◽

Vol 23 (16_suppl) ◽

pp. 850-850

Author(s):

M. Vanhuyse ◽

C. Fournier ◽

M.-E. Bonneterre ◽

J. Bonneterre

Keyword(s):

Breast Cancer ◽

Overall Survival ◽

Cancer Patients ◽

Early Breast Cancer ◽

Disease Free Survival ◽

Breast Cancer Patients ◽

Free Survival ◽

Disease Free

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Weight control strategies in breast cancer patients: A systematic review.

Journal of Clinical Oncology ◽

10.1200/jco.2016.34.3_suppl.179 ◽

2016 ◽

Vol 34 (3_suppl) ◽

pp. 179-179

Author(s):

Nathalie LeVasseur ◽

Mark J. Clemons ◽

Sasha Mazzarello ◽

Lisa Vandermeer ◽

Lee Jones ◽

...

Keyword(s):

Breast Cancer ◽

Waist Circumference ◽

Cancer Patients ◽

Weight Control ◽

Control Strategies ◽

Recurrence Free Survival ◽

Breast Cancer Patients ◽

Free Survival ◽

Exercise Interventions ◽

Weight Control Strategies

179 Background: Obesity remains an underestimated contributor to global cancer incidence and cancer-related mortality. Accumulating evidence suggests excessive energy intake and suboptimal levels of physical activity may be important after the diagnosis of cancer and may influence recurrence and overall survival(OS). Objective: Conduct a systematic review to evaluate data from randomized trials of weight control strategies used in breast cancer patients. Methods: A systematic search of Medline, Embase and the Cochrane Register of Controlled Trials through April 2015 was performed. Randomized trials of weight management strategies in breast cancer patients were sought. Outcomes studied included; change in weight, BMI and waist circumference, disease-free survival, recurrence-free survival and OS survival. Random effects meta-analyses were planned provided that included studies were considered to be clinically and methodologically homogenous. Results: Of 2876 abstracts, 312 were retained for review of the full texts. Overall 43 publications describing 40 studies met inclusion criteria. Of 12,801 enrolled patients, 11,597 had breast cancer. Fifteen studies consisted of dietary interventions, 17 consisted of exercise interventions and 8 consisted of both dietary and exercise interventions. Endpoints included: changes in weight (32 studies, 7,861 pts), BMI (12 studies, 1,886 pts), waist circumference (10 studies, 702 pts), recurrence-free survival (4 studies, 6105 pts) and overall survival (2 studies, 3,330 pts). Network meta-analyses of available data are in progress. Study results suggest that weight control strategies including dietary and exercise interventions were effective at reducing weight, BMI and waist circumference. Two large studies showed statistically significant recurrence-free survival benefits with weight control strategies and one showed OS benefit with an exercise intervention. Conclusions: Data from included trials suggest benefits of weight control strategies to decrease weight, BMI and waist circumference. Few trials have been designed to detect PFS or OS benefits. Larger trials are warranted to better define the role of weight control strategies in the management of breast cancer patients.

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The contribution of axillary lymph node volume to recurrence-free survival status in breast cancer patients with sub-stratification by molecular subtypes and pathological complete response

10.21203/rs.3.rs-57680/v1 ◽

2020 ◽

Author(s):

James Kang ◽

Haifang Li ◽

Renee Cattell ◽

Varsha Talanki ◽

Jules A Cohen ◽

...

Keyword(s):

Breast Cancer ◽

Lymph Node ◽

Cancer Patients ◽

Axillary Lymph Node ◽

Molecular Subtypes ◽

Complete Response ◽

Axillary Lymph ◽

Recurrence Free Survival ◽

Breast Cancer Patients ◽

Free Survival

Abstract Purpose This study sought to examine the contribution of axillary lymph node (LN) volume to recurrence-free survival (RFS) in breast cancer patients with sub-stratification by molecular subtypes, and full or nodal PCR.Methods The largest LN volumes per patient at pre-neoadjuvant chemotherapy on standard clinical breast 1.5-Tesla MRI, 3 molecular subtypes, full, breast, and nodal PCR, and 10-year RFS were tabulated (N = 110 patients from MRIs of I-SPY-1 TRIAL). A volume threshold of two standard deviations was used to categorize large versus small LNs for sub stratification. In addition, “normal” node volumes were determined from a different cohort of 218 axillary LNs.Results LN volume (4.07 ± 5.45 cm3) were significantly larger than normal axillary LN volumes (0.646 ± 0.657 cm3, P = 10− 16). Full and nodal pathologic complete response (PCR) was not dependent on pre-neoadjuvant chemotherapy nodal volume (P > .05). The HR+/HER2– group had smaller axillary LN volumes than the HER2 + and triple-negative groups (P < .05). Survival was not dependent on pre-treatment axillary LN volumes alone (P = .29). However, when substratified by PCR, the large LN group with full (P = .011) or nodal PCR (P = .0026) both showed better recurrence-free survival than the small LN group. There was significant difference in RFS when the small node group was separated by the 3 molecular subtypes (P = .036) but not the large node group (P = .97).Conclusions This study found an interaction of axillary lymph node volume, pathological complete responses, and molecular subtypes that inform recurrence-free survival status. Improved characterization of the axillary lymph nodes has the potential to improve the management of breast cancer patients.

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