scholarly journals Total Intravenous Anesthesia versus Inhalation Anesthesia for Breast Cancer Surgery

2019 ◽  
Vol 130 (1) ◽  
pp. 31-40 ◽  
Author(s):  
Seokha Yoo ◽  
Han-Byoel Lee ◽  
Wonshik Han ◽  
Dong-Young Noh ◽  
Sun-Kyung Park ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Overall Survival ◽  
Retrospective Cohort ◽  
Cancer Recurrence ◽  
Cancer Surgery ◽  
Breast Cancer Surgery ◽  
Recurrence Free Survival ◽  
Inhalation Anesthesia ◽  
Free Survival ◽  
Volatile Anesthesia

Abstract EDITOR’S PERSPECTIVE What We Know about This Topic IV anesthesia may impair anticancer immunity less than volatile anesthesia and therefore reduce recurrence risk What This Article Tells Us That Is New In a large propensity-matched retrospective cohort analysis, the authors compared total IV and volatile anesthesia for breast cancer surgery Recurrence hazard was similar with each approach Selection of IV or volatile anesthesia should be based on factors other than cancer recurrence Background The association between type of anesthesia used and recurrence of cancer remains controversial. This retrospective cohort study compared the influence of total IV anesthesia and inhalation anesthesia on the primary outcome of recurrence-free survival after breast cancer surgery. Methods The authors reviewed the electronic medical records of patients who had breast cancer surgery at a tertiary care teaching hospital between January 2005 and December 2013. The patients were grouped according to whether IV or inhalation anesthesia was used for surgery. Propensity score matching was used to account for differences in baseline characteristics. Kaplan–Meier survival curves were constructed to evaluate the influence of type of anesthesia on recurrence-free survival and overall survival. The risks of cancer recurrence and all-cause mortality were compared between each type of anesthesia. Results Of 7,678 patients who had breast cancer surgery during the study period, data for 5,331 patients were available for analysis (IV group, n = 3,085; inhalation group, n = 2,246). After propensity score matching, 1,766 patients remained in each group. Kaplan–Meier survival curves showed that there was no significant difference in recurrence-free survival or overall survival between the two groups, with 5-yr recurrence-free survival rates of 93.2% (95% CI, 91.9 to 94.5) in the IV group and 93.8% (95% CI, 92.6 to 95.1) in the inhalation group. Inhalation anesthesia had no significant impact on recurrence-free survival (hazard ratio, 0.96; 95% CI, 0.69 to 1.32; P = 0.782) or overall survival (hazard ratio, 0.96; 95% CI, 0.69 to 1.33, P = 0.805) when compared with total IV anesthesia. Conclusions The authors found no association between type of anesthesia used and the long-term prognosis of breast cancer. The results of this retrospective cohort study do not suggest specific selection of IV or inhalation anesthesia for breast cancer surgery.

scholarly journals Does the type of anesthesia really affect the recurrence-free survival after breast cancer surgery?

Oncotarget ◽  
2017 ◽  
Vol 8 (52) ◽  
pp. 90477-90487 ◽  
Author(s):  
Myoung Hwa Kim ◽  
Dong Wook Kim ◽  
Joo Heung Kim ◽  
Ki Young Lee ◽  
Seho Park ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Surgery ◽  
Breast Cancer Surgery ◽  
Recurrence Free Survival ◽  
Free Survival

Comparison of Survival Outcomes for Axillary Surgery Extent Based on Intraoperative Sentinel Lymph Node Biopsy Result After Neoadjuvant Chemotherapy for Breast Cancer

2021 ◽  
Author(s):  
Jung Whan Chun ◽  
Jisun Kim ◽  
Il Yong Chung ◽  
Beom Seok Ko ◽  
Hee Jeong Kim ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Overall Survival ◽  
Lymph Node ◽  
Sentinel Lymph Node ◽  
Neoadjuvant Chemotherapy ◽  
Axillary Recurrence ◽  
Recurrence Free Survival ◽  
Free Survival ◽  
Axillary Surgery ◽  
Distant Metastasis Free Survival

Abstract PurposeTo investigate the survival difference between limited axillary surgery and full axillary lymph node dissection (ALND) in patients with 1-3 positive sentinel lymph node biopsies (SLNBs) after neoadjuvant chemotherapy (NAC).MethodWe retrospectively analyzed data from 676 patients who underwent surgery between 2007 and 2017 with cT1-4, cN0-3, cM0 breast cancer at the time of diagnosis and 1-3 positive SLNBs after NAC. The patients received either SLNB only or completed level I or II ALND based on SLNB results. After propensity score matching, 483 patients who had undergone SLNB only (n=188) and ALND (n=295) were included. We examined overall survival, axillary recurrence-free survival, regional recurrence-free survival, and distant metastasis-free survival and compared them between the subgroups.ResultAt a median follow-up of 59.4 months, no significant statistical difference was observed in overall survival, axillary recurrence-free survival, regional recurrence-free survival, and distant metastasis-free survival between SLNB only and ALND. No significant differences were observed in the 5-year axillary recurrence-free survival (93.1% vs. 94.0%, hazard ratio [HR]=0.94, 95% confidence interval [CI]=0.43-2.05, p=0.876) and 5-year overall survival (97.7% vs. 97.3%, HR=1.65, 95% CI=0.58-4.65, p=0.347) between the two groups.ConclusionOur analysis suggests that SLNB alone may be a possible option for patients with 1-3 sentinel node-positive breast cancer following NAC without significant compromise of recurrence or overall survival.

scholarly journals Racial Differences in Time to Breast Cancer Surgery and Overall Survival in the US Military Health System

JAMA Surgery ◽  
2019 ◽  
Vol 154 (3) ◽  
pp. e185113 ◽  
Author(s):  
Yvonne L. Eaglehouse ◽  
Matthew W. Georg ◽  
Craig D. Shriver ◽  
Kangmin Zhu
Keyword(s):  
Breast Cancer ◽  
Overall Survival ◽  
Health System ◽  
Racial Differences ◽  
Cancer Surgery ◽  
Breast Cancer Surgery ◽  
Military Health System ◽  
Military Health ◽  
Us Military ◽  
The Us

scholarly journals Association between the Dietary Inflammatory Index and Risk for Cancer Recurrence and Mortality among Patients with Breast Cancer

Nutrients ◽  
2018 ◽  
Vol 10 (8) ◽  
pp. 1095 ◽  
Author(s):  
Hyeonjeong Jang ◽  
Min Chung ◽  
Shin Kang ◽  
Yongsoon Park
Keyword(s):  
Breast Cancer ◽  
Overall Survival ◽  
Cancer Recurrence ◽  
Disease Free Survival ◽  
Dietary Inflammatory Index ◽  
Free Survival ◽  
Inflammatory Index ◽  
Node Metastasis ◽  
Disease Free ◽  
Overall Mortality

The dietary inflammatory index (DII) has been associated with breast cancer incidence and survival. However, the association between DII and cancer recurrence and mortality among patients with breast cancer has not been investigated. Therefore, the present study aimed to investigate whether DII was positively associated with risk for cancer recurrence and overall mortality among patients with breast cancer. Among 511 women (51.9 ± 10.7 years; stage 0–3) who underwent breast cancer surgery, 88 had cancer recurrence, and 44 died during follow–up until 213 months (average disease free survival of 84.3 ± 42.4 months and overall survival of 69.3 ± 38.9 months). The DII assessed after surgery (5.4 ± 5.2 months after diagnosis) was significantly higher in patients with recurrence than those without recurrence, and Cox proportional hazards regression analysis showed that it was positively associated with the risk for cancer recurrence (hazard ratio (HR) 2.347, confidence interval (CI) 1.17–4.71) and overall mortality (HR 3.049, CI 1.08–8.83) after adjusting for confounding factors. Disease-free survival and overall survival rates were significantly lower in patients with higher DII scores. In addition, the DII was positively associated with the risk for cancer recurrence according to prognostic factors, such as age (<50 years), premenopausal status, body mass index (≥25 kg/m2), HR+, tumor size (>2 cm), and presence of lymph node metastasis. The present study showed that anti-inflammatory diets may decrease the risk of cancer recurrence and overall mortality in patients with breast cancer, particularly those with prognostic factors, such as younger age, premenopausal status, obesity, HR+ breast cancer, tumor size >2 cm, and presence of lymph node metastasis.

Ki-67 expression in residual triple-negative breast tumors after neoadjuvant chemotherapy to predict for recurrence-free survival.

2012 ◽  
Vol 30 (30_suppl) ◽  
pp. 89-89 ◽  
Author(s):  
Joseph A. Pinto ◽  
Franco F. Doimi ◽  
Justin M. Balko ◽  
Carlos L. Arteaga ◽  
Henry L. Gómez
Keyword(s):  
Breast Cancer ◽  
Neoadjuvant Chemotherapy ◽  
Triple Negative Breast Cancer ◽  
Retrospective Cohort ◽  
Triple Negative ◽  
Breast Tumors ◽  
Recurrence Free Survival ◽  
Nodal Involvement ◽  
Ki 67 ◽  
Free Survival

89 Background: Ki-67 expression in breast cancer has been described as predictive of pathological complete response and prognostic of recurrence free survival (RFS). Our aim was to evaluate in a retrospective cohort of triple negative breast cancer patients if tumor proliferation measured by ki-67 expression is correlated with the outcome. Methods: We evaluated a retrospective cohort of 109 cases of triple negative breast cancer (ER-, PR- and HER2- determined by immunohistochemistry). Ki-67 labeling index was determined in Formalin-Fixed, Paraffin-Embedded residual tumors after neoadjuvant chemotherapy. Patients were stratified in Ki67<15% and Ki67≥15%. Clinicopathological data was retrieved from clinical records. RFS and overall survival (OS) were calculated using the Kaplan–Meier method and variables compared using the log-rank or Breslow test and Hazard Ratios (HR) estimated by the Cox regression. Results: The median age for patients was 47.5 years, 55 (50.5%) were premenopausal and 54 (49.5%) postmenopausal. Eight patients (7.3%) were clinical stages II and 101 (92.7%) stages III. Median of Ki-67 expression was 35.97% (0.96% - 77.7%). There was not association between Ki-67 expression (<15% VS ≥15%) with tumor size, nodal involvement, clinical stage and menopausal status. After a median of follow of 21.6 months, 62 patients (56.9%) have relapsed and 53 (48.6%) have die. The median time for RFS and OS were 21.2 and 31.4 months, respectively. Median of RFS was 12.6 months for Ki67<15% vs 21.2 months for Ki67≥15%, P=0.421 (HR=0.91). Median of OS was 34.9 months for Ki67<15% vs 31.4 months for Ki67≥15%, P=0.755 (HR=1.18). Only nodal involvement was found predictor of shorter RFS (0 nodes, 25.2 months vs 1 -3 nodes, 26.1 months, vs >3 nodes, 9.4 months, P=0.020). Conclusions: Ki-67 labeling index was not related with the outcome in terms of OS and RFS in patients with residual triple negative breast tumors that were treated with neoadjuvant chemotherapy.

Evaluating the prognostic significance of JAK2 in distant breast cancer recurrence.

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. e22178-e22178
Author(s):  
Carl Anthony Blau ◽  
Christopher P. Miller ◽  
Amanda N. Kortum ◽  
Jason D. Thorpe ◽  
Michel Schummer ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Validation Cohort ◽  
Prognostic Significance ◽  
Cancer Recurrence ◽  
Distant Recurrence ◽  
Breast Cancer Recurrence ◽  
Mrna Levels ◽  
Recurrence Free Survival ◽  
Free Survival ◽  
Control Study

e22178 Background: Estrogen, progesterone, and epidermal growth factor receptor ligands stimulate growth in a subset of breast cancers, however recent studies suggest roles for additional factors such as interleukins-6 and 8, prolactin, and erythropoietin. These and other growth factors act upon ligand-specific receptors to activate janus kinase 2 (JAK2), and JAK2 inhibitors are under investigation as a novel targeted therapy. We tested whether erythropoietin receptor (EPOR) or JAK2 mRNA levels are associated with distant breast cancer recurrence. Methods: We used quantitative RT-PCR to measure mRNA levels of JAK2, EPOR and a series of control genes using archival tumors from 112 women who experienced distant breast cancer recurrence (cases) and 112 tumors from women who did not (controls). Cases and controls were matched for tumor size, lymphovascular invasion, nodal status, extra-nodal extension, and ER/PR/HER2. Recurrence risks were evaluated using logistic regression. Associations between mRNA levels (via microarray data) and recurrence-free survival were validated in an independent cohort from the Netherlands Cancer Institute (n=295) using Cox proportional hazards regression. Results: Increasing JAK2 mRNA levels strongly correlated with a reduced risk of distant recurrence in our case control study (univariate p=0.0004, multivariate p=0.003), and with improved recurrence-free survival in the validation cohort (univariate p=0.0009; multivariate p=0.003). Remarkably, in the validation cohort, the ranking of the prognostic significance of JAK2 (top 3.5% of ~25,000 genes) was comparable to the known strong prognostic indicator of recurrence, ESR1 (top 1.3%). Similarly although less prominently, increasing EPORmRNA levels were significantly associated with reduced distant recurrence in our case control study (continuous model: univariate p=0.01, multivariate p=0.05) and with improved recurrence free survival in the validation cohort in univariate (p=0.03) but not multivariate analysis (p=0.35). Conclusions: JAK2 mRNA levels in breast tumors correlate with a reduced risk of recurrence. Understanding the mechanistic basis for this association is important for the rational application of JAK2 inhibitors.

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