scholarly journals Localized Cutaneous Adverse Event Induced by Anastrozole as Adjuvant Treatment for Breast Cancer: A Case Report

2019 ◽  
Vol 11 (1) ◽  
pp. 57-63 ◽  
Author(s):  
Aya Tanaka ◽  
Chigusa Yamashita ◽  
Haruna Hinogami ◽  
Hirohiko Shirai ◽  
Jun Yamamura ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Endothelial Cells ◽  
Adverse Event ◽  
Adjuvant Treatment ◽  
Hormone Receptor ◽  
Vascular Endothelial Cells ◽  
Left Breast ◽  
Receptor Expression ◽  
Hormone Receptor Positive ◽  
Cutaneous Adverse Event

Cutaneous adverse events caused by aromatase inhibitors have been reported to be rare. We describe a rare case of a cutaneous adverse event that developed in a cancer-affected breast after aromatase inhibitor treatment. A 72-year-old postmenopausal female patient who was diagnosed with stage IA breast cancer received anastrozole as adjuvant treatment. Six months after the initiation of anastrozole, she developed an irregularly shaped purpuric plaque with several purpuric papules surrounding the postoperative scar on her left breast. Histological findings revealed capillary vessel proliferation and expansion, with hemorrhage in the superficial dermis. Immunohistochemistry of the skin biopsy specimen revealed hormone receptor expression limited to the vascular endothelial cells of the proliferating and expanding vessels. We believe that anastrozole induced a change in the local estrogen level, which affected the hormone receptor-positive endothelial cells in the dermis near the primary lesion of the breast cancer and caused a cutaneous adverse event only in the aforementioned area.

scholarly journals Composite risk and benefit from adjuvant dose-dense chemotherapy in hormone receptor-positive breast cancer

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Fabio Puglisi ◽  
Lorenzo Gerratana ◽  
Matteo Lambertini ◽  
Marcello Ceppi ◽  
Luca Boni ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Treatment Effect ◽  
Hormone Receptor ◽  
Recurrence Risk ◽  
Receptor Expression ◽  
Phase Iii ◽  
Composite Measure ◽  
Node Positive ◽  
Hormone Receptor Positive ◽  
Dose Dense

AbstractThe GIM2 phase III trial demonstrated the benefit of dose-dense chemotherapy in node-positive early breast cancer (eBC). To better define the dose-dense effect in the hormone receptor-positive subgroup, we evaluated its benefit through a composite measure of recurrence risk. We conducted an ancillary analysis of the GIM2 trial evaluating the absolute treatment effect through a composite measure of recurrence risk (CPRS) in patients with hormone receptor-positive HER2-negative eBC. CPRS was estimated through Cox proportional hazards models applied to the different clinicopathological features. The treatment effect was compared to the values of CPRS by using the Sub-population Treatment Effect Pattern Plot (STEPP) process. The Disease-Free Survival (DFS)-oriented STEPP analysis showed distinct patterns of relative treatment effect with respect to CPRS. Overall, 5-year DFS differed across CPRS quartiles ranging from 95.2 to 66.4%. Each CPRS quartile was characterized by a different patients’ composition, especially for age, lymph node involvement, tumor size, estrogen and progesterone receptor expression, and Ki-67. A number needed to treat of 154 and 6 was associated with the lowest and the highest CPRS quartile, respectively. Dose-dense adjuvant chemotherapy showed a consistent benefit in node-positive eBC patients with hormone receptor-positive HER2-negative disease, but its effect varied according to CPRS.

Impact of obesity in postmenopausal early breast cancer patients receiving frontline adjuvant aromatase inhibitors.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. e11020-e11020 ◽  
Author(s):  
Ugur Sahin ◽  
Ibrahim Petekkaya ◽  
Cagatay Arslan ◽  
Saim Furkan Sarici ◽  
Mustafa Solak ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Aromatase Inhibitors ◽  
Adjuvant Treatment ◽  
Hormone Receptor ◽  
Postmenopausal Breast Cancer ◽  
Type I ◽  
Obese Patients ◽  
Hormone Receptor Positive ◽  
Significant Difference

e11020 Background: Aromatase inhibitors (AIs), anastrozole (ANA) and letrozole (LET), have been shown to be more effective than tamoxifen in the adjuvant treatment of postmenopausal hormone receptor positive breast cancer. However, data from preclinical studies and subgroup analyses of some major clinical trials suggest differring efficacy among AIs. Yet the best clinical choice is still not very clear. This retrospective study aims at comparing the results of treatment with either AI among different subgroups of patients, especially among the obese patients. Methods: Between 2006-2011, 335 women with stage I to IIIC hormone receptor positive postmenopausal breast cancer treated with either ANA or LET as adjuvant treatment were included. Body mass index (BMI), estrogen and progesterone receptor (ER and PR) and HER-2 status at the time of diagnosis were recorded. Patients were grouped as BMI ≤ 30 and BMI > 30. The Kaplan-Meier survival estimates were calculated. Subgroups were compared with the log rank test. A 5 % type-I error was used to infer statistical significance. Results: The percentage of patients receiving ANA or LET were 47.2% and 57.8%, respectively. Median age at diagnosis was 58 (42-84) and lower in the ANA group (p=0.04). Stage II to IIIC disease was present in 76.8 % and the distribution was similar between ANA and LET (p=0.84). Median time of follow-up was 29 months (6-124) and median duration of hormonotherapy was 29 months (3-68) and similar between two groups (p=0.52 and p=0.55, respectively). Of the patients 41.2 % had a BMI of > 30. There was no significant difference in overall (OS) and progression-free (PFS) survivals between ANA and LET (p=0.08 and p=0.94, respectively). However, among patients with a BMI of > 30 a statistically insignificant benefit in PFS was observed with LET (p=0.1). ER, PR and HER2 status had no significant impact on OS and PFS. Conclusions: In a median follow-up of 29 months letrozole and anastrozole yielded similar OS and PFS. However, among patients with a BMI of > 30, LET might bring about a PFS advantage. In selected obese patients LET might be a reasonable choice in this setting. Larger studies with long term follow-up are needed to reach an exact conclusion.

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