scholarly journals Adjuvant chemotherapy in elderly breast cancer patients: Pattern of use and impact on overall survival

2019 ◽  
Vol 30 ◽  
pp. v64
Author(s):  
A. Berthelot ◽  
A. De Nonneville ◽  
J.-M. Classe ◽  
M. Cohen ◽  
F. Reyal ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Overall Survival ◽  
Adjuvant Chemotherapy ◽  
Cancer Patients ◽  
Breast Cancer Patients

Proliferation-based prediction for overall survival in locally advanced HER2(+) breast cancer.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. e12007-e12007
Author(s):  
Manuel Pedregal ◽  
Federico Rojo ◽  
Cristina Carames Sanchez ◽  
Francisco Lobo ◽  
Yann Izarzugaza ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Overall Survival ◽  
Adjuvant Chemotherapy ◽  
Cancer Patients ◽  
Tumor Cells ◽  
Locally Advanced ◽  
Luminal Breast Cancer ◽  
Breast Cancer Patients ◽  
Ki67 Expression ◽  
Her2 Breast Cancer

e12007 Background: Breast cancer prognosis is influenced by several factors including Ki67 expression which may have a predictive role in luminal breast cancer patients. The aim of this study was to assess the value of Ki67 in breast cancers with positive hormonal receptors and HER2 overexpressed and to evaluate its impact on survival. Methods: Seventy eight consecutive patients diagnosed with locally advanced HER2 positive breast cancer who were treated with adjuvant therapy based on HER2 treatment were selected for this study (2004-2014). The adjuvant chemotherapy schemes were 44% TCH, 16% FEC, 11% AC/T and 29% other therapies. The median of followup was 68 months. Tumor proliferation was assessed immunohistochemically by Ki67 expression and calculated as percentage of stained tumor cells from this cohort previous to adjuvant chemotherapy administration and the results obtained were correlated with disease status and outcome. Results: High proliferation defined as a percentage > 15 of tumor cells was observed in 69% of the breast cancer patients cases. High proliferation significantly predicted longer overall survival (OS) (Log rank 0,012). At 10 years of follow-up, 93% of the patients with KI67 high expression were alive versus 43% of patients without overexpression. Multivariate analysis confirmed the clinical significance of Ki67 predicting OS for luminal HER2 breast cancer patients (p 0,04 y HR 9,6). Conclusions: High proliferation identifies a setting of luminal-B HER2+ subtype breast cancer patients with a significantly longer overall survival.

Predictors of adjuvant chemotherapy for breast cancer patients with an intermediate Oncotype-DX score: A SEER-based population study.

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. e12014-e12014
Author(s):  
Sowmya Goranta ◽  
Tarek Haykal ◽  
Areeg Bala ◽  
Ragheed Al-Dulaimi ◽  
Ghassan Bachuwa ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Overall Survival ◽  
Multivariate Analysis ◽  
Adjuvant Chemotherapy ◽  
Cancer Patients ◽  
Recurrence Score ◽  
Oncotype Dx ◽  
Breast Cancer Patients ◽  
T Stage ◽  
Grade Iii

e12014 Background: Oncotype-DX Assay is a 21-gene based recurrence score (RS) that helps stratify breast cancer patients based on their risk of recurrence. It is often used to help identify patients that may benefit from adjuvant chemotherapy (AC). Prior to the TAILORx Trial results, there were no guidelines for AC in patients with an intermediate score (18-30). Management of these patients was often at the clinical judgement of the provider. We sought to determine predictors of AC among these patients, and measure treatment effect on survival. Methods: We queried the Surveillance, Epidemiology, and End-Results database for breast cancer patients newly diagnosed between 2010-2015. We included patients with T1-T3, hormone receptor positive, HER2-negative, and lymph node-negative breast cancer with an intermediate RS. Male patients, those younger than 40 years, tumors 5 mm or less, and incomplete records were excluded. Univariate and multivariate analysis was performed to derive independent predictors of AC. Cox Proportional-Hazards Model was done to examine the effect of AC on survival. Results: We included 14,710 patients of whom 4,508 (30.6%) received AC. Patients that received AC were younger (55.4 years [8.8] vs 60.0 [9.7], p < 0.001), grade III or higher (29.8% vs 16.4%, p < 0.001), and had a higher RS (23.9 [3.6] vs 21.5 [3.1], p < 0.001). Higher T stage was associated with a higher rate of patients receiving AC (p < 0.001). Marital status was also associated with AC; a higher proportion of patients who received AC were married (67.9% vs 64.4%, p < 0.001). There was no significant association between race/ethnicity or insurance type with AC. Multivariate analysis showed that RS (OR: 1.24 [1.23-1.26], p < 0.001), T stage (OR: 1.67 [1.21-2.30], p < 0.001), and a grade III tumor (OR: 1.85 [1.64-2.09], p < 0.001) were the strongest predictors of AC. The age decile 80-89 years (OR: 0.05 [0.02-0.10], p < 0.001) was the most negative predictor of AC. AC did not have an effect on 5 year overall survival (97.6% vs 96.0%, p = 0.28). Conclusions: Between 2010-2015, our study shows 30.6% of breast cancers patients with an intermediate Oncotype-DX score were given AC. The decision to treat was largely based on tumor size, grade and age. AC had no effect on overall survival.

Is there a survival benefit with adjuvant chemotherapy for patients with stage I (T1N0) triple negative breast cancer?

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. e11547-e11547
Author(s):  
T. H. Luu ◽  
S. Lau ◽  
R. Nelson ◽  
M. Ottochian ◽  
A. Garcia ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Overall Survival ◽  
Adjuvant Chemotherapy ◽  
Cancer Patients ◽  
Triple Negative Breast Cancer ◽  
Survival Benefit ◽  
Triple Negative ◽  
Stage I ◽  
P Value ◽  
Breast Cancer Patients

e11547 Background: Chemotherapy is the only systemic modality for patients with breast cancer lacking expression of estrogen, progesterone, and HER2 receptors (triple negative), a group comprising 15% of all breast cancers. The majority of such patients present with nodal metastases. The median time to distant recurrence is short: at 2.6 years, and median time to death is 4.2 years. (Dent R, et al. Triple-Negative Breast Cancer: Clinical Features and Patterns of Recurrence, Clin Cancer Res 2007; 13(15) August, 2007). The benefit from proceeding with adjuvant chemotherapy for ≤2cm, node negative triple negative breast cancer remains undefined. Patients and Methods: A retrospective chart review was conducted to assess the benefit of adjuvant chemotherapy for overall survival for stage I (T1N0) triple-negative breast cancer treated from 1996 to 2006 at City of Hope and USC. ER, PR, and HER2 status (as assessed by fluorescent in-situ hybridization (FISH) or immunohistochemistry) were reviewed and confirmed. Overall survival was defined as time from date of diagnosis to date of death. All patients received standard surgery ± radiation. Results: A total of 100 stage I triple-negative breast cancer patients were identified. The median age at diagnosis was 56 (range 27–91). Of the 100 patients, 59 received adjuvant chemotherapy: 38 received anthracycline-based, 17 received non-anthracycline-based regimens and 4 were unknown. Median length of follow-up was 4.0 years. No difference in overall survival was found in patients who received adjuvant chemotherapy (p-value = 0.94). Similarly, there was no difference between patients who received non-anthracycline-based chemotherapy versus those given anthracycline-based chemotherapy (p-value=0.17). The group of patients who received adjuvant chemotherapy were younger (51.8 y.o versus 61.5 y.o (p=0.0004)) and had larger tumor size (13.6mm versus 10.2mm (p=0.0002)). Lack of statistical significance may be related to the limited sample size. Conclusion: We did not find a statistically survival benefit of adjuvant chemotherapy in 100 triple negative stage I breast cancer patients. Further studies are needed to clarify the role of adjuvant chemotherapy in this group of patients. No significant financial relationships to disclose.

Analysis of pattern, time, and risk factors influencing recurrence in triple-negative breast cancer patients.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. e11553-e11553
Author(s):  
Anna Niwinska ◽  
Katarzyna Pogoda ◽  
Magdalena Murawska ◽  
Tadeusz Pienkowski
Keyword(s):  
Breast Cancer ◽  
Overall Survival ◽  
Adjuvant Chemotherapy ◽  
Cancer Patients ◽  
Tumor Size ◽  
Triple Negative ◽  
Neoadjuvant Treatment ◽  
Breast Cancer Patients ◽  
Factors Influencing ◽  
The Brain

e11553 Background: The aim of the study was to assess the rate, pattern and time of recurrence in patients with triple-negative breast cancer (TNBC) treated in one institution. The second goal was to evaluate factors influencing recurrence and overall survival in this group of patients. Methods: 2534 consecutive breast cancer patients were diagnosed at the Cancer Center and Institute of Oncology in Warsaw, Poland, between January 2005 and December 2006. Out of 2534 patients, 228 (9%) were TNBC (ER/PR/HER2-negative). The clinicopathological characteristics were determined using descriptive statistics. The overall survival (OS) and disease-free survival (DFS) were calculated using the Kaplan-Meier method. The univariate and multivariate analyses were developed to identify factors influencing recurrence and survival in TNBC patients. Results: Most of the patients were diagnosed with stage II or III breast cancer (47% and 34%, respectively), the median age at diagnosis was 54.5 years. The most common histological type was ductal cancer (81%). 31% of patients were treated with neoadjuvant chemotherapy and 49% with adjuvant chemotherapy – almost all consisted of anthracyclines. 6 years of observation revealed that the metastatic disease occurred in 35% of all TNBC patients: 15% in the brain, 14% in the lungs, 11% in the bones, 8% in the liver and 14% had locoregional relapse. The highest risk of recurrence was during the first 3 years after primary treatment and then during the next two years of observation it did not change. Median DFS and OS were not reached at the time of analysis, 6-year DFS and OS were 68% and 62%, respectively.Factors influencing recurrence were: tumor size and systemic adjuvant chemotherapy while factors influencing overall survival were: tumor size, nodal status, adjuvant/neoadjuvant treatment and metastases in the brain, liver and bones. Conclusions: Characteristic pattern of recurrence in time was revealed. The tumor size was responsible for recurrence despite lack of involvement of lymph nodes. Aggressive adjuvant/neoadjuvant treatment ordered in all clinical stages of TNBC (including N0) was factor responsible for avoiding local and distant relapse and prolonging overall survival.

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