scholarly journals Impact of preoperative breast MRI on 10-year survival of patients included in the Swedish randomized multicentre POMB trial

BJS Open ◽  
2021 ◽  
Vol 5 (5) ◽  
Author(s):  
V Gonzalez ◽  
B Arver ◽  
L Löfgren ◽  
L Bergkvist ◽  
K Sandelin ◽  
...  

Abstract Background The value of preoperative breast MRI as an adjunct technique regarding its effect on re-excision rates has been a subject of discussion. No survival data regarding preoperative breast MRI are available from randomized studies. Methods Ten-year follow-up of the POMB randomized multicentre study was analysed, evaluating MRI and its effect on disease-free survival (DFS) and overall survival (OS). Patients with newly diagnosed breast cancer were randomized to either preoperative MRI or conventional imaging. Kaplan–Meier plots were used to analyse DFS and OS, and Cox regression to estimate hazard ratios (HRs). Results A total of 440 patients, aged 56 years or less, with newly diagnosed breast cancer were randomized to either preoperative MRI (220) or conventional imaging (220; control). Median follow-up for each group was 10 years. DFS rates were 85.5 and 80.0 per cent for the MRI and control groups respectively (P = 0.099). The risk of relapse or death was 46 per cent higher in the control group (HR 1.46, 95 per cent c.i. 0.93 to 2.29). OS rates after 10 years were 90.9 and 88.6 per cent in the MRI and control groups respectively (P = 0.427). The risk of death was 27 per cent higher in the control group (HR 1.27, 0.71 to 2.29). Locoregional, distant, and contralateral recurrence outcomes combined were increased in the control group (P = 0.048). A subgroup analysis of patients with breast cancer stages I–III showed that preoperative MRI improved DFS compared with conventional imaging, but this did not reach statistical significance (P = 0.057). Conclusion After 10 years of follow-up, preoperative breast MRI as an adjunct to conventional imaging resulted in slightly, but non-significantly, improved DFS and OS. Registration number: NCT01859936 (http://www.clinicaltrials.gov).

2021 ◽  
Author(s):  
Pegah Mohammadzadeh ◽  
Elnaz Shaseb ◽  
Zohreh Sanaat ◽  
Parvin Sarbakhsh ◽  
Nasrin Gholami ◽  
...  

Abstract Purpose Peripheral neuropathy is a complication of taxane that in severe cases can limit the optimal treatment. The aim of this study was to evaluate the efficacy of memantine in prevention of docetaxel induced peripheral neuropathy in patients with breast cancer. Methods In this randomized clinical trial, 40 women between the ages of 18 and 64 years with non-metastatic breast cancer (stages I to III) were included (registry number: IRCT20160310026998N9 and registry date: 26 March 2019). All patients were treated with the AC-T regimen (with docetaxel). Patients in intervention group received memantine at a dose of 20 mg for 8 weeks at the beginning of the first cycle of docetaxel. Patients in control group did not take any medication for neuropathy prevention. To assess the neuropathy, DN4 and CTCAE questionnaires were used at baseline, one months, three months and six months after the intervention. Results The DN4 questionnaire score was remarkably less in memantine group in follow up one (p-value: 0.033) and three (p < 00.1). The CTCAE follow up score did not change during study. The Neuropathy duration and Neuropathy onset, were shown significant difference between the intervention and control groups, p = 0.050 and p = 0.001, respectively. From 40 patients, 8 (40%) in memantine group and 2 (10%) in control group, did not experience any kind of neuropathy. Conclusion Data showed that prophylactic administration of memantine 20 mg/day has been effective in prevention of severity and incidence of docetaxel induced neuropathy in patients with breast cancer.


2021 ◽  
Author(s):  
Hee-Cheol Kim ◽  
Ji-Hun Kim ◽  
Ho-Jun Lee ◽  
Yang-Tae Kim ◽  
Byeong-Churl Jang

Abstract Background Some studies suggest that cancer and type 2 diabetes (T2D), as well as neurodegenerative disease (ND), are related to protein misfolding and possibly to each other. This study aimed to investigate the association between NDs and cancer to evaluate the impact of T2D on the association between NDs and cancer. Methods A population-based 10-year follow-up study was conducted using the Korean National Health Insurance Service Database between 2002 and 2015. The study population included an ND group (n = 9,292) and control group (n = 46,742), aged ≥ 60 years. A multivariable Cox proportional hazards regression model was used to evaluate the hazard ratio (HR) and 95% confidence interval (CI) for cancer risk. Results Various NDs and/or T2D were newly diagnosed in ND and control groups during the 10-year follow-up periods. Newly developed ND cases before cancer onset were 2,412 (26.0%) in the ND group and 15,435 (33.0%) in the control group (χ2 = 178.19, p < 0.01). Newly developed T2D cases before cancer onset were 4,691 (50.5%) and 25,695 (55.0%) in the ND and control groups, respectively (χ2 = 62.89, p < 0.01). As of December 31, 2015 (the end of the observation period), the number of cancer patients in the ND group was 2,040 (22.0%) and that in the control group was 8,628 (18.5%) (χ2 = 61.45, p < 0.01). The ND group was associated with an increased risk of cancer (HR, 1.25; 95% CI, 1.19–1.31). In both groups, newly diagnosed ND and T2D patients showed an additive effect on cancer incidence during the follow-up period. The additional effect on cancer incidence was higher in T2D than in ND. Conclusion This study showed a positive association between NDs and cancer, and an additive effect of T2D on this association. Further replication studies are needed to address the association among NDs, cancer, and T2D.


2021 ◽  
Author(s):  
Hee-Cheol Kim ◽  
Ji-Hun Kim ◽  
Ho-Jun Lee ◽  
Yang-Tae Kim ◽  
Byeong-Churl Jang

Abstract BackgroundSome studies suggest that cancer and type 2 diabetes (T2D), as well as neurodegenerative diseases (NDs), are related to protein misfolding and possibly to each other. This study aimed to investigate the association between NDs and cancer, and to determine the impact of T2D on the association between NDs and cancer.MethodsA population-based 10-year follow-up study was conducted using the Korean National Health Insurance Service Database between 2002 and 2015. The study population included an ND group (n = 9,292) and control group (n = 46,742), aged ≥60 years. A multivariable Cox proportional hazards regression model was used to evaluate the hazard ratio (HR) and 95% confidence interval (CI) for cancer risk.ResultsVarious another NDs and/or T2D were newly diagnosed in ND and control groups during the 10-year follow-up periods. Newly developed another ND cases before cancer onset were 2,412 (26.0%) in the ND group and 15,435 (33.0%) in the control group (χ2 = 178.19, p < 0.01). Newly developed T2D cases before cancer onset were 4,691 (50.5%) and 25,695 (55.0%) in the ND and control groups, respectively (χ2 = 62.89, p < 0.01). As of December 31, 2015 (the end of the observation period), the number of cancer patients in the ND group was 2,040 (22.0%) and that in the control group was 8,628 (18.5%) (χ2 = 61.45, p < 0.01). The ND group was associated with an increased risk of cancer (HR, 1.25; 95% CI, 1.19–1.31). In both groups, newly diagnosed another NDs and T2D showed an additive effect on cancer incidence during the follow-up period. The additive effect on cancer incidence was higher in T2D than in ND.ConclusionThis study showed a positive association between NDs and cancer, and an additive effect of T2D on this association. Further replication studies are needed to address the association among NDs, cancer, and T2D.


Cancers ◽  
2021 ◽  
Vol 13 (11) ◽  
pp. 2576
Author(s):  
Vincent Chin-Hung Chen ◽  
Chin-Kuo Lin ◽  
Han-Pin Hsiao ◽  
Bor-Show Tzang ◽  
Yen-Hsuan Hsu ◽  
...  

Background: We aimed to investigate the associations of breast cancer (BC) and cancer-related chemotherapies with cytokine levels, and cognitive function. Methods: We evaluated subjective and objective cognitive function in BC patients before chemotherapy and 3~9 months after the completion of chemotherapy. Healthy volunteers without cancer were also compared as control group. Interleukins (IL) 2, 4, 5, 6, 10, 12p70, 13, 17A, 1β, IFNγ, and TNFα were measured. Associations of cancer status, chemotherapy and cytokine levels with subjective and objective cognitive impairments were analyzed using a regression model, adjusting for covariates, including IQ and psychological distress. Results: After adjustment, poorer performance in semantic verbal fluency was found in the post-chemotherapy subgroup compared to controls (p = 0.011, η2 = 0.070); whereas pre-chemotherapy patients scored higher in subjective cognitive perception. Higher IL-13 was associated with lower semantic verbal fluency in the post-chemotherapy subgroup. Higher IL-10 was associated with better perceived cognitive abilities in the pre-chemotherapy and control groups; while IL-5 and IL-13 were associated with lower perceived cognitive abilities in pre-chemotherapy and control groups. Our findings from mediation analysis further suggest that verbal fluency might be affected by cancer status, although mediated by anxiety. Conclusions: Our findings suggest that verbal fluency might be affected by cancer status, although mediated by anxiety. Different cytokines and their interactions may have different roles of neuroinflammation or neuroprotection that need further research.


2021 ◽  
Author(s):  
Wen-Pei Wu ◽  
Chih-Yu Chen ◽  
Chih-Wei Lee ◽  
Hwa-Koon Wu ◽  
Shou-Tung Chen ◽  
...  

Abstract Background: Women with unilateral breast cancer are at an increased risk for the development of contralateral breast cancers. We hypothesis that combined breast MRI would detect more contralateral synchronous breast cancer than conventional imaging alone, and resulted in less contralateral metachronous breast cancer during follow-up. Methods: In this case control analysis, we retrospectively collected two groups of patients for evaluating the effectiveness and value of adding pre-operative breast MRI to conventional breast images (mammography and sonography) for detection of contralateral synchronous breast cancer. The new metachronous contralateral breast cancer diagnosed during follow-up was prospectively evaluated and compared. Results: Group A (n=733) comprised patients who underwent conventional preoperative imaging and group B (n=735) combined with MRI were enrolled and compared. Seventy (9.5%) of the group B patients were found to have contralateral lesions detected by breast MRI, and 65.7% of these lesions only visible with MRI. The positive predictive value of breast MRI detected contralateral lesions was 48.8%. With the addition of breast MRI to conventional imaging studies, more surgical excisions were performed in contralateral breasts (6% (44/735) versus 1.4% (10/733), P< 0.01), more synchronous contralateral breast cancer detected (2.9% (21/735) versus 1.1% (8/733), P=0.02), and resulted in numerical less (2.2% (16/714) versus 3% (22/725), p=0.3) metachronous contralateral breast cancer during a mean follow-up of 102 months. Conclusions: Combining pre-operative breast MRI evaluation resulted in an increase of contralateral synchronous breast cancer detection, and a numerical less subsequent contralateral metachronous breast cancer occurrence compared to conventional imaging alone.


2019 ◽  
Vol 98 (8) ◽  
pp. NP125-NP130
Author(s):  
Serhan Derin ◽  
Selvet Erdogan ◽  
Murat Sahan ◽  
Mehmet Fatih Azik ◽  
Hatice Derin ◽  
...  

Ocular and ophthalmological adverse effects may be seen in β-thalassemia major (BTM) patients treated with regular blood transfusions and iron-chelating agents. We hypothesized that olfactory dysfunction may be present in this population. In this study, we aimed to investigate olfactory dysfunction in patients with BTM and determine the etiological factors. A total of 43 patients with BTM were included in the study. Forty-three patients without any nasal complaints, history of facial trauma, or nasal surgery were included as the controls. All participants had nasal endoscopy. The iron-chelating agents used, their duration of use, as well as hemoglobin and ferritin levels of the BTM patients were recorded. Sniffin’ Sticks test (SST) was used to assess olfactory functions, and BTM and control groups were compared for the results. The correlations of SST scores with the other study parameters were analyzed. Eight (18.6%) of 43 patients in the BTM group had hyposmia while none of the patients in the control group had hyposmia ( P < .001). Older age, low-hemoglobin level, and longer use of deferoxamine were found to be correlated with olfactory dysfunction. Olfactory dysfunction may be seen in BTM patients treated with iron-chelating agents. The results of this study suggest that screening for olfactory function may be needed in routine follow-up of BTM patients.


2020 ◽  
Vol 21 (1) ◽  
Author(s):  
Suenghwan Jo ◽  
Sang Hong Lee ◽  
Se Woong Jang ◽  
Hyun Bai Choi ◽  
Ba Rom Kim ◽  
...  

Abstract Background Resuming driving is a common concern among patients undergoing hip arthroscopy. The present study aimed to assess whether patients who had undergone right hip arthroscopy presented with poorer driving performance than patients with normal hips and to analyze the time required to regain preoperative driving performance. Methods Forty-seven patients who had undergone right hip arthroscopy and consented to our test protocol were included in this study. Using an immersive driving simulator, the patients were tested for their brake reaction time (BRT), total brake time (TBT), and brake pedal depression (BPD) preoperatively and postoperatively. The first postoperative assessments were conducted when the patients could comfortably sit on the driving seat, and the follow-up assessments were conducted for 6 consecutive weeks at weekly intervals. The patients were divided into the following two groups based on the type of surgery that they underwent: the femoroacetabular impingement (FAI) surgery group and the simple hip arthroscopy (SA) group. Twenty healthy volunteers underwent driving assessments thrice at weekly intervals and constituted the control group. The braking parameters were compared between preoperative and postoperative measurements and among the FAI surgery, SA, and control groups. Results The preoperative braking parameters of the patients who underwent arthroscopy did not differ significantly from those of the controls (p = 0.373, 0.763, and 0.447 for the BRT, TBT, and BPD, respectively). All braking parameters returned to normal in 2 weeks in the FAI surgery group and in 1 week in the SA group. Conclusions Our study suggests that the driving performance of patients who underwent right hip arthroscopy is comparable to that of individuals with normal hips and that the braking parameters may normalize to the preoperative state at 1 week after SA and 2 weeks after FAI surgery.


1987 ◽  
Vol 5 (3) ◽  
pp. 354-364 ◽  
Author(s):  
G N Hortobagyi ◽  
G P Bodey ◽  
A U Buzdar ◽  
D Frye ◽  
S S Legha ◽  
...  

Fifty-nine evaluable patients under 65 years of age with measurable metastatic breast cancer and without prior chemotherapy were randomly assigned to treatment with fluorouracil, Adriamycin (Adria Laboratories, Columbus, OH), and cyclophosphamide (FAC) at standard or high doses (100% to 260% higher than standard FAC) following a dose escalation schedule. Patients randomized to the high-dose FAC received the first three cycles of therapy within a protected environment. Subsequent cycles for this group were administered at standard doses of FAC in an ambulatory setting, the same as for the control group. After reaching 450 mg/m2 of Adriamycin, patients in both groups continued treatment with cyclophosphamide, methotrexate, and fluorouracil until there was disease progression. Analysis of pretreatment patient characteristics showed an even distribution for most known pretreatment factors, although the control group had slightly (but nonsignificantly) more favorable prognostic characteristics. Fourteen patients (24%) achieved a complete remission (CR) and 32 (54%) achieved a partial remission (PR), for an overall major response rate of 78%. There were no differences in overall, CR, or PR rates between the high-dose FAC and control groups. The median response durations were 11 and 10 months for the protected environment and control groups, respectively, and the median survival was 20 months for both groups. Hematologic, gastrointestinal (GI), and infection-related complications were significantly more frequent and severe in the group treated with high-dose chemotherapy. Stomatitis, diarrhea, and skin toxicity were dose-limiting. However, there were no treatment-related deaths. High-dose induction combination chemotherapy with the agents used in this study failed to increase the response rate or survival duration, and resulted in a substantial increase in toxicity.


2020 ◽  
pp. 1321103X1987107
Author(s):  
Elif Guven

This study examines how piano-accompanied solfège reading practices of preservice music teachers ( N = 28) affect their performance on their musical hearing, reading, and writing (MHRW) classes. A pretest–posttest design with control groups was employed. The data were analyzed by 2 × 2 split-plot analysis of variance (ANOVA) and one-way ANOVA. Consequently, a significant difference was not found between the MHRW performance scores of the experimental and control groups. An analysis of mean performance scores revealed that the scores received by the control group were higher than those of the experimental group after the practice. Follow-up interviews that were held with 14 students after the experimental implementation revealed that students believed piano-accompanied courses were more useful, and they felt more comfortable with piano accompaniment. Although MHRW performance scores indicated that piano-accompanied solfège reading practices did not have a significant effect on preservice music teachers’ MHRW performances, it helped them participate in courses more enthusiastically.


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