How To Use Prognostic Factors in Axillary Node-Negative Breast Cancer Patients

1990 ◽  
Vol 82 (12) ◽  
pp. 1006-1015 ◽  
Author(s):  
William L. McGuire ◽  
Atul K. Tandon ◽  
D. Craig Allred ◽  
Gary C. Chamness ◽  
Gary M. Clark
Keyword(s):  
Breast Cancer ◽  
Prognostic Factors ◽  
Cancer Patients ◽  
Axillary Node ◽  
Breast Cancer Patients ◽  
Node Negative ◽  
Node Negative Breast Cancer

scholarly journals Tumor-Biological Factors Upa and PAI-1 as Stratification Criteria of a Multicenter Adjuvant Chemotherapy Trial in Node-Negative Breast Cancer

2000 ◽  
Vol 15 (1) ◽  
pp. 73-78 ◽  
Author(s):  
A. Prechtl ◽  
N. Harbeck ◽  
C. Thomssen ◽  
C. Meisner ◽  
M. Braun ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Adjuvant Chemotherapy ◽  
Cancer Patients ◽  
Plasminogen Activator ◽  
Systemic Therapy ◽  
Axillary Node ◽  
Breast Cancer Patients ◽  
Node Negative ◽  
Node Negative Breast Cancer ◽  
Pai 1

In axillary node-negative primary breast cancer, 70% of the patients will be cured by locoregional treatment alone. Therefore, adjuvant systemic therapy is only needed for those 30% of node-negative patients who will relapse after primary therapy and eventually die of metastases. Traditional histomorphological and clinical factors do not provide sufficient information to allow accurate risk group assessment in order to identify node-negative patients who might benefit from adjuvant systemic therapy. In the last decade various groups have reported a strong and statistically independent prognostic impact of the serine protease uPA (urokinase-type plasminogen activator) and its inhibitor PAI-1 (plasminogen activator inhibitor type 1) in node-negative breast cancer patients. Based on these data, a prospective multicenter therapy trial in node-negative breast cancer patients was started in Germany in June 1993, supported by the German Research Association (DFG). Axillary node-negative breast cancer patients with high levels of either or both proteolytic factors in the tumor tissue were randomized to adjuvant CMF chemotherapy versus observation only. Recruitment was continued until the end of 1998, by which time 684 patients had been enrolled. Since then, patients have been followed up in order to assess the value of uPA and PAI-1 determination as an adequate selection criterion for adjuvant chemotherapy in node-negative breast cancer patients. This paper reports on the rationale and design of this prospective multicenter clinical trial, which may have an impact on future policies in prognosis-oriented treatment strategies.

New prognostic factors associated with long-term survival in node-negative breast cancer patients

Breast Cancer ◽  
1999 ◽  
Vol 6 (4) ◽  
pp. 370-377 ◽  
Author(s):  
Takao Kato ◽  
Tsunehito Kimura ◽  
Nobue Takami ◽  
Ryuhei Miyakawa ◽  
Schinichi Tanaka ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Prognostic Factors ◽  
Cancer Patients ◽  
Breast Cancer Patients ◽  
Term Survival ◽  
Node Negative ◽  
Long Term Survival ◽  
Factors Associated ◽  
Node Negative Breast Cancer

The analyses of disease free survival and overall survival in premenopausal and postmenopausal axillary node negative breast cancer patients

2006 ◽  
Vol 24 (18_suppl) ◽  
pp. 10757-10757
Author(s):  
N. D. Bajic ◽  
D. D. Scepanovic
Keyword(s):  
Breast Cancer ◽  
Overall Survival ◽  
Prognostic Factors ◽  
Disease Free Survival ◽  
Axillary Node ◽  
Breast Cancer Patients ◽  
Free Survival ◽  
Node Negative ◽  
Node Negative Breast Cancer ◽  
Significant Difference

10757 Background: The aim of this study was to analyse in which order known traditional prognostic factors predict disease free survival (DFS) and overall survival (OS) in breast cancer patients (pts) who are patohystologicaly axillary node negative. Methods: From 1998 till 2004, 258 patients were treated of axillary node negative breast cancer. We analysed 3 and 5 years (yrs) DFS and 3 and 5 yrs OS for all patients as well as for premenopausal (96 pts, 37%) and postmenopausal (162 pts, 63%). The mean follow-up time for DFS was 60 months (mo) (min 30, max 136 mo) and for OS was 66 mo (min 36, max 140 mo). As prognostic factors for DFS and OS, age, tumour size, HG as well as adjuvant treatment (locoregional and systemic) were analysed accordingly. Fifty two patients (20%) were HG1 while 190 pts (74%), were HG2 & 3; 30 pts (11%) had tumour up to 1cm and 157 pts (61%) had tumours up to 3cm and 71 pts (28%) above 3cm. Radical mastectomy was performed in 92 pts (36%) while conservative surgery were performed in 166 pts (64%). Systemic therapy was applied in 224 pts (87% of which 57% were treated with hormonotherapy). Results: 3 yrs DFS for 258 treated pts were 87% - there was no statistically significant difference among pre- and postmenopausal pts; 5 yrs DFS were 73% with no statistically significant difference among pre- and postmenopausal group of pts (p > 0.05). 3 yrs overall survival were 94% and 5 yrs 80% with no statistically significant difference among pre- and postmenopausal pts (p > 0.05). There were statistically different DFS and OS among those pts treated with adjuvant radiotherapy as well as for those with adjuvant systemic therapy in both group of pts (p < 0.001). Also as independent prognostic factor for DFS and OS were HG (Cox regression model). Conclusions: Although, HG and adjuvant therapy are the most important prognostic factors for DFS and OS in premenopausal and postmenopausal patients, we found that there is no statistically significant difference between the groups respectively. However, life-expectancy for premenopausal patients is longer. Therefore further adjuvant therapy research is needed to achieve better DFS and OS in this group of pts. No significant financial relationships to disclose.

Prognostic factors and natural history in lymph node-negative breast cancer patients

1992 ◽  
Vol 21 (2) ◽  
pp. 101-109 ◽  
Author(s):  
Rodrigo Arriagada ◽  
Lars Erik Rutqvist ◽  
Lambert Skoog ◽  
Hemming Johansson ◽  
Andrew Kramar
Keyword(s):  
Breast Cancer ◽  
Prognostic Factors ◽  
Lymph Node ◽  
Natural History ◽  
Cancer Patients ◽  
Breast Cancer Patients ◽  
Node Negative ◽  
Node Negative Breast Cancer

Prognostic Factors in Node-Negative Breast Cancer Patients

1990 ◽  
pp. 31-41
Author(s):  
Ingegerd Balslev ◽  
Karin Zedeler ◽  
Susan M. Thorpe ◽  
Birgitte Bruun Rasmussen ◽  
Henning T. Mouridsen
Keyword(s):  
Breast Cancer ◽  
Prognostic Factors ◽  
Cancer Patients ◽  
Breast Cancer Patients ◽  
Node Negative ◽  
Node Negative Breast Cancer

scholarly journals Urokinase Plasminogen Activator and Its Inhibitor, PAI-1, as Prognostic Markers in Breast Cancer: From Pilot to Level 1 Evidence Studies

2002 ◽  
Vol 48 (8) ◽  
pp. 1194-1197 ◽  
Author(s):  
Michael J Duffy
Keyword(s):  
Breast Cancer ◽  
Cancer Patients ◽  
Plasminogen Activator ◽  
Poor Prognosis ◽  
Axillary Node ◽  
Breast Cancer Patients ◽  
Node Negative ◽  
Node Negative Breast Cancer ◽  
Level 1 ◽  
Pai 1

Abstract Background: For optimum management of patients with cancer, accurate assessment of prognosis is essential. The primary determinant of outcome in malignancy is the formation of distant metastases. Urokinase plasminogen activator (uPA) is a serine protease causally involved in invasion and metastasis. Content: Data from model systems show that uPA is unequivocally involved in cancer dissemination. Consistent with its role in metastasis, multiple independent groups have shown that high uPA concentrations in primary breast cancers correlate with poor prognosis. For determining outcome, the prognostic impact of uPA was both independent of traditionally used factors and prognostic in patients with axillary node-negative disease. Paradoxically, high concentrations of plasminogen activator inhibitor (PAI-1), an endogenous inhibitor of uPA, also correlate with poor prognosis in patients with breast cancer, including the subgroup with node-negative disease. The prognostic value of uPA/PAI-1 in axillary node-negative breast cancer patients was recently confirmed in both a prospective randomized trial and a pooled analysis, i.e., two different level 1 evidence (LOE-1) studies. Conclusions: uPA and PAI-1 are among the first biological prognostic factors to have their clinical value validated using LOE-1 evidence studies. Determination of these analytes may help identify low-risk node-negative breast cancer patients for whom adjuvant chemotherapy is unnecessary.

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