Outcome Evaluation in Pre-Trastuzumab Era between Different Breast Cancer Phenotypes: A Population-Based Study on Italian Women

2012 ◽  
Vol 98 (6) ◽  
pp. 743-750 ◽  
Author(s):  
Laura Cortesi ◽  
Elisabetta De Matteis ◽  
Claudia Cirilli ◽  
Luigi Marcheselli ◽  
Manuela Proietto ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Overall Survival ◽  
Triple Negative ◽  
Disease Free Survival ◽  
Luminal A ◽  
Free Survival ◽  
Luminal B ◽  
Italian Women ◽  
Disease Free ◽  
Over Time

Aims and background Based on estrogen receptor (ER), progesterone receptor (PgR) and Her2/neu (HER2) expression, four breast cancer subtypes have been distinguished: luminal A (ER and/or PgR/HER2–, Ki67 <14%), luminal B (ER and/or PgR/HER2–, Ki67 ≥14% or ER and/or PgR/HER2), triple-negative (ER-/PgR-/HER2–), and HER2 (ER-/PgR-/HER2). Our aim was to evaluate the prognosis of these phenotypes in the pre-trastuzumab era in a large cohort of Italian women. Methods and study design We studied 2347 breast cancer patients, in stage I-II, registered by the Modena Cancer Registry from 1999 to 2006 in the Modena province, Italy. Overall survival, disease-free survival and second non-mammary tumors were evaluated. Results A total of 1868 luminal A (79.6%), 195 luminal B (8.3%), 205 triple-negative (8.7%) and 79 HER2 (3.4%) patients were identified. A better prognosis was observed for luminal A than for luminal B, HER2 and triple-negative subtypes (5-year overall survival, 91% vs 89% vs 87% vs 86%, respectively, P <0.001). Disease-free survival for pT1a and pT1b tumors was worse in HER2 (82%) than in triple-negative (90%), luminal B (95%) and luminal A (97%) (P = 0.013). Finally, luminal B patients had a significantly higher rate of second non-mammary tumors than the other groups. Conclusions In the pre-trastuzumab era, luminal A patients showed a better 5-year overall survival than luminal B, HER2 and triple-negative patients, but in terms of disease-free survival, HER2 subtype represented an unfavorable group over time, whereas the triple-negative group had an increased risk of relapse in the first 42 months and then decreased. Among each prognostic factor, ER <10%, Ki67 >14% and HER2 overexpression are considered as risk factors, but only HER2 positivity seems to preserve the role over time.

Development of prognostic nomograms using institutional data for patients with triple-negative breast cancer

2021 ◽  
Author(s):  
Jie-Yu Zhou ◽  
Kang-Kang Lu ◽  
Wei-Da Fu ◽  
Hao Shi ◽  
Jun-Wei Gu ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Overall Survival ◽  
Triple Negative Breast Cancer ◽  
Triple Negative ◽  
Predictive Accuracy ◽  
Area Under The Curve ◽  
Disease Free Survival ◽  
Discriminative Ability ◽  
Free Survival ◽  
Disease Free

Background: Triple-negative breast cancer (TNBC) is an aggressive disease. Nomograms can predict prognosis of patients with TNBC. Methods: A total of 745 eligible TNBC patients were recruited and randomly divided into training and validation groups. Endpoints were disease-free survival and overall survival. Concordance index, area under the curve and calibration curves were used to analyze the predictive accuracy and discriminative ability of nomograms. Results: Based on the training cohort, neutrophil-to-lymphocyte ratio, positive lymph nodes, tumor size and tumor-infiltrating lymphocytes were used to construct a nomogram for disease-free survival. In addition, age was added to the overall survival nomogram. Conclusion: The current study developed and validated well-calibrated nomograms for predicting disease-free survival and overall survival in patients with TNBC.

The prognostic importance of triple negative breast cancer: A population based study in India

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. e22219-e22219
Author(s):  
B. S. Ajaikumar ◽  
R. Rao ◽  
J. Prabhu ◽  
J. D. Kulkarni ◽  
P. K ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Overall Survival ◽  
Regression Analysis ◽  
Cancer Patients ◽  
Triple Negative ◽  
Disease Free Survival ◽  
Breast Cancer Patients ◽  
Free Survival ◽  
Node Status ◽  
Disease Free

e22219 Background: Triple-negative (ER-negative, PR-negative, HER2/neu negative) breast cancer has distinct clinical and pathologic features, and is a clinical problem because of its typically high grade, relatively poor prognosis, aggressive behavior and lack of targeted therapies leaving chemotherapy as the mainstay of treatment. This study envisaged to analyse the influence of triple negativity status on survival and disease free survival in prospective cohort of breast cancer patients. Methods: Breast tumors of 215 women aged 30–75, diagnosed from 2004 were tested for ER, PR and HER2 positivity by immunohistochemistry and correlated with clinical outcomes such as recurrence, disease free survival and overall survival using Kaplan Meiers Survival analysis and Coxs regression analysis. The study cohort was followed up for 60 months or until death whichever was earlier. Results: Triple negativity significantly influenced disease free survival (46 ± 3, 41, 52) vs. non triple negative cohort (mean ± SE; 95%CI, 37 ± 2; 32, 40) and log rank = 2.1, p = 0.04. However triple negativity did not influence overall survival in months (56 ± 0; 55, 56) vs. non triple negative cohort (43 ± 1; 42, 45), (log rank = 1.78, p = 0.16). However, the mean disease free survival was (45 ± 7; 32, 58) months for patients >40 years age vs (37 ± 4; 33, 39) for patients < 40 years of age (log rank = 2.87, p =0.02). Stage of disease, node status, grade and menopausal status did not influence disease free survival significantly. However, Cox regression analysis did not predict significant effects of triple negativity on overall survival or disease free survival when controlled for confounding factors such as age, node status, stage etc Conclusions: Our observations suggest that triple negativity can significantly affect progression of breast cancer in Indian breast cancer patients and longer follow up is necessary (10 years) to determine its effects on survival. No significant financial relationships to disclose.

scholarly journals Association between obesity with disease-free survival and overall survival in triple-negative breast cancer

Medicine ◽  
2018 ◽  
Vol 97 (19) ◽  
pp. e0719 ◽  
Author(s):  
Lin Mei ◽  
Lin He ◽  
Yuhua Song ◽  
Yang Lv ◽  
Lijiu Zhang ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Overall Survival ◽  
Triple Negative Breast Cancer ◽  
Triple Negative ◽  
Disease Free Survival ◽  
Free Survival ◽  
Disease Free

scholarly journals PROGNOSTIC VALUE OF TUMOR STROMA RATIO IN TRIPLE NEGATIVE BREAST CANCER

2021 ◽  
Vol 74 (3) ◽  
pp. 565-571
Author(s):  
Liubov M. Zakhartseva ◽  
Mariia A. Yanovytska
Keyword(s):  
Breast Cancer ◽  
Overall Survival ◽  
Triple Negative Breast Cancer ◽  
Prognostic Value ◽  
Triple Negative ◽  
Disease Free Survival ◽  
Tumor Stroma ◽  
Breast Carcinomas ◽  
Free Survival ◽  
Disease Free

The aim: The purpose of this study is to investigate prognostic value of tumor stroma ratio in triple negative breast carcinomas. Materials and methods: This cohort retrospective study included a total number of 232 previously untreated operational materials with primary stage I-III triple negative breast cancer. The median follow-up period was 3.8 years for overall survival and 3.2 years for disease-free survival. Tumor stroma ratio was evaluated by two pathologists (Kappa coefficient was 0.71 and 0.84, respectively). Results: Kaplan-Meier curves with logrank test statistically significantly showed relationship between tumor stroma ratio and both overall and disease-free survival. The Cox proportional hazards model showed tumor stroma ratio is a strong independent prognostic factor for triple negative breast carcinomas with hazard ratios of 2.11 (p=0.002) for overall survival and 1.83 (p=0.004) for disease-free survival in multivariate analysis. Conclusions: Triple negative breast tumors with high stroma ratio have worse overall and disease-free survival compared to low stroma ratio tumors. Investigation of tumor stroma ratio doesn't require any additional costs and slide preparation. It can be added to routine breast cancer investigation to expand knowledge about cancer prognosis.

scholarly journals The Effect of Perioperative Bevacizumab on Disease-Free and Overall Survival in Locally Advanced HER-2 Negative Breast Cancer: A Meta-Analysis

2018 ◽  
Vol 12 ◽  
pp. 117822341879225 ◽  
Author(s):  
Yanal Alnimer ◽  
Zakaria Hindi ◽  
Khalil Katato
Keyword(s):  
Breast Cancer ◽  
Overall Survival ◽  
Triple Negative Breast Cancer ◽  
Triple Negative ◽  
Meta Analysis ◽  
Disease Free Survival ◽  
Standard Chemotherapy ◽  
Free Survival ◽  
Her 2 ◽  
Disease Free

Introduction: Multiple trials demonstrated that adding Bevacizumab to the standard neoadjuvant chemotherapy in HER-2 negative breast cancer increases pathological complete response. We conducted this meta-analysis to evaluate that effect on survival. Methods: We performed a systematic search for randomized trials measuring the effect of adding either neoadjuvant or adjuvant Bevacizumab to the standard chemotherapy on disease-free and overall survival in breast cancer surgical candidates. The Mantel-Haenszel method and random effect model were used to analyze the data. A total of 7 randomized controlled trials were included in the analysis with a mean follow-up of 45 months. Results: No statistically significant difference in overall survival was found after adding Bevacizumab to the standard chemotherapy in the overall study population, HR=0.9, 95% CI (90.72–1.13), estrogen/ progesterone positive subgroup, HR=0.99, 95% CI (0.72–1.35), or in triple negative breast cancer, HR=0.88, 95% CI (0.77–1.01). However, there was a small but significant improvement in disease-free survival in triple negative breast cancer with a HR of 0.88, 95% CI (0.78–0.98), but not in estrogen/ progesterone receptor positive tumors, HR=1.01, 95% CI (0.81–1.26). Conclusions: The addition of Bevacizumab along with the standard chemotherapy would not improve overall survival in breast cancer surgical candidates, however, due to a small but significant improvement on disease-free survival in triple negative breast cancer, that would not eliminate the possibility of a certain subgroup of the latter who might benefit from adding Bevacizumab.

Distant disease-free survival (DDFS) discrimination capacity of various pathologic complete response (pCR) definitions according to breast cancer subtypes.

2013 ◽  
Vol 31 (26_suppl) ◽  
pp. 162-162
Author(s):  
Masaya Hattori ◽  
Keitaro Matsuo ◽  
Mari Ichikawa ◽  
Takashi Fujita ◽  
Masataka Sawaki ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Triple Negative ◽  
Disease Free Survival ◽  
Roc Curves ◽  
Luminal A ◽  
Distant Disease ◽  
Free Survival ◽  
Cancer Subtypes ◽  
Luminal B

162 Background: pCR has been postulated to be correlated with long-term clinical benefits in some subtypes of breast cancer. Here, we analyzed the discriminatory ability and the predictive power of various pCR definitions for distant disease-free survival (DDFS) according to breast cancer subtypes. Methods: We analyzed 326 (114 Luminal A: ER+/PR+/HER2-, 44 Luminal B/HER2-: ER+/PR-/HER2-, 51 Luminal B/HER2+: ER+/PR+ and/or -/HER2+, 51 HER2: ER-/PR-/HER2+, and 66 Triple negative: ER-/PR-/HER2-) non-metastatic breast cancer patients (pts) who had received neoadjuvant chemotherapy at our institution between January 2003 and June 2012. Four pCR definitions were used: ypT0ypN0, ypT0/isypN0, ypT0/isypN0/+, ypT<1micypN0/+. DDFS was estimated by Kaplan-Meier method, and analyzed by log-rank test and Cox proportional hazard model. The receiver operating characteristic (ROC) curves analysis was used for comparing DDFS prediction models with and without various pCR definitions in addition to other covariates (tumor stage, nodal status, BMI, tumor grade, use of trastuzumab) as variables. Results: The pCR rate was comparatively low in Luminal A and high in HER2. 94.1% of HER2 and 74.5% of Luminal B/HER2+ received total 1 year of trastuzumab therapy. In multivariate analysis, no pCR definitions were associated with improved DDFS significantly in Luminal A, Luminal B/HER2-, Luminal B/HER2+ and HER2, whereas each pCR definition was associated with improved DDFS in Triple negative (ypT0ypN0: HR0.12, p=0.043, ypT0/isypN0: HR0.06, p=0.007, ypT0/isypN0/+: HR0.107, p=0.004, ypT<1micypN0/+: HR0.104, p=0.003). In the ROC curves analysis of triple-negative, a DDFS prediction model including pCR defined as ypT0/isypN0 showed the highest accuracy, but low statistical significance (AUC: 0.834 vs.0.749 p=0.076). Conclusions: pCR could discriminate good and poor prognosis groups only in Triple negative and pCR defined as ypT0/isypN0 has the potential to provide better discrimination in this subtype. The predictive power of pCR for long term clinical benefit in other subtypes may not be obvious due to the influence of effective adjuvant therapies.

Survival outcomes in Egyptian patients with triple-negative breast cancer: Single institute experience.

2015 ◽  
Vol 33 (28_suppl) ◽  
pp. 158-158 ◽  
Author(s):  
Mona Kamal Jomaa ◽  
Ahmed Aly Nagy
Keyword(s):  
Breast Cancer ◽  
Overall Survival ◽  
Triple Negative Breast Cancer ◽  
Median Overall Survival ◽  
Triple Negative ◽  
Disease Free Survival ◽  
Survival Outcomes ◽  
Free Survival ◽  
Disease Free ◽  
Grade Iii

158 Background: Triple-negative breast cancer (TNBC) is a unique subtype and consider as an aggressive disease without established targeted treatment options. This study conducted to determine the incidence, characteristics, and survival outcomes of TNBC patients in an Egyptian cancer institute. Methods: Medical records of 520 patients treated between 2010-2011 in Clinical Oncology Department-Ain Shams University-Egypt were analyzed. Cox proportional hazards models were used to evaluate the association between TNBC and DFS and OS after adjusting for other covariates. Results: Among the 520 patients, 139 were TNBC .The median age was 50 years (SD±11.767, Range 20-80 ) versus 52 years (SD±12.134, Range 20-80), median tumor diameter was 5 cm (SD± 1.408, Range 1-7) versus was 5 cm (SD± 1.401, Range 1-7) , and median number of positive axillary LN was 3 (SD± 4.779, Range 0-37) versus 3 (SD± 4.832, Range 0-25) in non TNBC and TNBC respectively . Median disease-free survival was 24 months (SD± 14.128, Range 1-69 ) versus 15 months (SD± 8.811, Range 1-43 ) and median overall survival was 41 months (SD± 16.249, Range 3-60) versus 31 months (SD± 12.184, Range 7-60 ) in non TNBC and TNBC respectively. About 85.6 % of the TNBC tumors were IDC, 4.4 % were ILC and 5% were mixed. About 1.4 % of the TNBC tumors were grade I, 70.5 % were grade II and 28.1% were grade III. Median disease-free survival was 24 months (95%CI 21.679- 26.321) versus 15 months (95%CI 12.587-17.413) (p< 0.001) and median overall survival was 44 months (95%CI 41.396-46.604) versus 31 months (95%CI 29.460-32.540) (p< 0.001) in non TNBC and TNBC respectively. In TNBC cohort , DFS was 12 months (95%CI 11.464-12.536) in patients with grade III tumors versus 25 months (95%CI 22.359-27.641 )in patients with other grades (p< 0.001), this was also reflected in OS as 29 months (95%CI 25.129-32.871 ) versus 44 months (95%CI 41.238-46.762 ) (p< 0.001). Conclusions: Multivariate analyses supported a conclusion that TNBC subtype was an independent adverse prognostic factor for survival along with other known risk factors such as tumor grade.

scholarly journals Overweight and prognosis in triple-negative breast cancer patients: a systematic review and meta-analysis

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Sixten Harborg ◽  
Robert Zachariae ◽  
Julia Olsen ◽  
Maja Johannsen ◽  
Deirdre Cronin-Fenton ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Systematic Review ◽  
Overall Survival ◽  
Triple Negative Breast Cancer ◽  
Observational Studies ◽  
Triple Negative ◽  
Meta Analysis ◽  
Disease Free Survival ◽  
Free Survival ◽  
Disease Free

AbstractWe conducted a systematic review and meta-analysis investigating the association between overweight and outcome in triple-negative breast cancer (TNBC) patients. We searched PubMed and Embase using variations of the search terms triple-negative breast cancer (population), overweight and/or obesity (exposure), and prognosis (outcome). Based on the World Health Organization guidelines for defining overweight, we included longitudinal observational studies, which utilized survival statistics with hazard ratios (HRs) in our analysis. The included studies measured body mass index at the time of diagnosis of TNBC and reported disease-free survival and/or overall survival. Study quality was assessed with the Newcastle-Ottawa Scale and study data were extracted using the Meta-analysis of Observational Studies in Epidemiology (MOOSE) checklist, independently by two authors. Random-effects models were used to combine the effect sizes (HRs), and the results were evaluated and adjusted for possible publication bias. Thirteen studies of 8,944 TNBC patients were included. The meta-analysis showed that overweight was associated with both shorter disease-free survival (HR = 1.26; 95%CI: 1.09–1.46) and shorter overall survival (HR = 1.29; 95%CI: 1.11c1.51) compared to normal-weight. Additionally, our Bayesian meta-analyses suggest that overweight individuals are 7.4 and 9.9 times more likely to have shorter disease-free survival and overall survival, respectively. In conclusion, the available data suggest that overweight is associated with shorter disease-free and overall survival among TNBC patients. The results should be interpreted with caution due to possible publication bias.

scholarly journals Analisis Survival Pasien Kanker Payudara Usia Muda di RSUP DR. M. Djamil Padang Tahun 2008-2017

2018 ◽  
Vol 7 ◽  
pp. 25
Author(s):  
M. Al Farisyi ◽  
Daan Khambri
Keyword(s):  
Breast Cancer ◽  
Overall Survival ◽  
Triple Negative Breast Cancer ◽  
Triple Negative ◽  
Disease Free Survival ◽  
Free Survival ◽  
Kaplan Meier ◽  
Disease Free

semua wanita yang didiagnosa kanker payudara. KPD usia muda berhubungan dengan progresifitas yang tinggi, kecenderungan untuk rekurensi dan prognosis yang lebih buruk dibandingkan KPD usia tua. Penelitian ini bertujuan untuk menilai outcome dari pasien KPD usia muda yang mendapatkan pengobatan di RSUP Dr. M. Djamil Padang dari tahun 2008-2017. Desain penelitian ini adalah kohort retrospektif dengan analisis data menggunakan Kaplan Meier dengan Log Rank, pada 71 pasien yang telah didiagnosis KPD secara histopatologi dan mendapatkan terapi (bedah, kemoterapi, radioterapi, hormonal terapi ataupun targetting terapi). Hasil penelitian menunjukkan insiden KPD terbanyak pada range usia 35-40 tahun, dengan ukuran tumor T3, diferensiasi derajat sedang, histopatologi tipe duktal karsinoma dengan Triple Negative Breast Cancer (TNBC) sebagai subtipe yang terbanyak. Disease Free Survival (DFS) didapatkan rata-rata 87.48 bulan dan Overall Survival (OS) sebesar 79.13 bulan. Ukuran tumor didapatkan sebagai faktor yang berhubungan terhadap DFS (p = 0.00).

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