Staging Breast Cancer - Screening for Occult Metastases

1985 ◽  
Vol 71 (4) ◽  
pp. 339-344 ◽  
Author(s):  
Stefano Ciatto ◽  
Paolo Pacini ◽  
Patrizia Bravetti ◽  
Luigi Cataliotti ◽  
Gaetano Cardona ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Early Detection ◽  
Detection Rate ◽  
Clinical Stage ◽  
Preoperative Staging ◽  
Stage I ◽  
Stage Iii ◽  
Prognostic Impact ◽  
Detection Rates ◽  
Occult Metastases

The authors report on 1,017 consecutive breast cancer cases without symptomatic metastases staged by means of chest X-ray (CXR), skeletal survey (BXR) and bone scintigraphy (BS). Occult metastases (DM) detection rate was 0.88 %: 0.29 % for lung and 0.59 % for bone DM. The detection rate was correlated with clinical stage: 0.36 % for stage I, 0.20 % for stage II, 0.26 % for stages I and II, and 2.77 % for stage III cases. The sensitivity based on DM cases prevalent or surfacing within 6 months of follow-up was 0.30 for CXR, 0.22 for BXR and 0.55 for BS; specificity was 0.99, 0.98 and 0.90, respectively. The study confirms the possibility of early detection of DM with preoperative staging, but the extremely low detection rates in stage I and II cancers do not advise such a routine procedure. The higher detection rate of DM may suggest adoption of the routine staging procedure in stage III cancers. In these cases, although no evidence is available of a favorable prognostic impact of early detection and treatment of DM, an unnecessary mastectomy could be avoided in about 3 % of cases in the presence of DM detected by the staging procedure.

Staging evaluation with bone scan, liver ultrasound, and chest radiograph in patients with primary breast cancer: A systematic review.

2012 ◽  
Vol 30 (27_suppl) ◽  
pp. 4-4
Author(s):  
Stuart-Allison Moffat Staley
Keyword(s):  
Breast Cancer ◽  
Chest Radiograph ◽  
Bone Scan ◽  
Detection Rate ◽  
Stage I ◽  
Stage Ii ◽  
Stage Iii ◽  
Detection Rates ◽  
Liver Ultrasound ◽  
Number Of Patients

4 Background: Routinely, radiological investigation with bone scan, chest radiograph, and liver ultrasound are employed as baseline staging tests. The aim of this review was to examine indications for this costly routine screening, and, thus, we posed the following question: Among women with newly diagnosed breast cancer who are otherwise asymptomatic, does evaluation with bone scanning, liver ultrasound, and chest radiograph help to determine the extent of metastatic disease? Methods: We searched PubMed and EMBASE databases for relevant articles to find articles using detection rate, defined as the number of patients with an abnormal test result divided by the total number of patients tested, as the primary outcome of interest. In addition to detection rate, false-positive and false-negative rates are reported if provided in the study reports reviewed. In order to obtain overall estimates of detection rates in each test, the results from the studies were pooled and summed according to pathological stage. A 95% confidence interval was calculated for each of the pooled rates. Results: Eight articles out of 232 reviewed were included in the final analysis. The following pooled detection rates for bone scan were calculated according to stage: Stage I 7 of 544 (1.29%), Stage II 29 of 938 (3.09%), Stage I and II 36 of 1,482 (2.43%), and Stage III 39 of 312 (12.5%). For liver ultrasound: Stage I 1 of 213 (0.47%), Stage II 4 of 400 (1.00%), Stage I and II 5 of 613 (0.82%), and Stage III 6 of 143 (4.20%). And, for chest radiograph: Stage I 0 of 223, Stage II 2 of 473 (0.42%), Stage I and II 9 of 1,782 (0.51%), and Stage III 8 of 175 (4.57%). Conclusions: The routine use of bone scan, liver ultrasound, and chest radiograph in the staging evaluation of primary breast cancer patients is of little value in detecting metastatic disease in women with clinical stage I and stage II cancer, and therefore, should not be performed.

scholarly journals Tumor-Infiltrating Lymphocytes in Breast Carcinoma: Immunohistochemical Analysis

2018 ◽  
Vol 3 (12) ◽  
Author(s):  
Dr. Amol R. R. Rajhans, MD ◽  
Dr. Deepak S. Howale
Keyword(s):  
Breast Cancer ◽  
Breast Carcinoma ◽  
T Lymphocytes ◽  
Clinical Stage ◽  
Stage Iv ◽  
Stage I ◽  
Stage Ii ◽  
Stage Iii ◽  
Cd4 Cells ◽  
Infiltrating Lymphocytes

Breast cancer is the most common invasive cancer in women, and the second main cause of cancer death in women, after lung cancer. Breast cancer is cancer that develops from breast tissue. Signs of breast cancer may include a lump in the breast, a change in breast shape, dimpling of the skin, fluid coming from the nipple, a newly inverted nipple, or a red or scaly patch of skin. In those with distant spread of the disease, there may be bone pain, swollen lymph nodes, shortness of breath, or yellow skin. In 2017, around 252, 710 new diagnoses of breast cancer are expected in women, and around 40,610 women are likely to die from the disease. Awareness of the symptoms and the need for screening are important ways of reducing the risk. Material and Methods: This retrospective study was carried out in the department of Pathology, DCP Consultant Pathologist Shashwat Hospitals, Pune, a total of 38 retrospective breast carcinoma tissues were obtained from female patients. Representative paraffin blocks and haematoxylin and eosin (HandE)-stained sections were retrieved from the pathology department. The patients' records were reviewed to look for the patient age and the clinical stage of the disease. The stage of the cancer was reported according to the American Joint Committee of Cancer. As tissue and patient data was collected in an anonymous way no written or informed consent was required for the study purpose. Results and Observations: According to data by clinical staging Stage I, Stage II, Stage III and Stage IV were 16 (42.11%), 11(28.95%), 7 (18.42%) and 4 (10.53%) respectively. According to histology Stage I, Stage II, Stage III and Stage IV were 2 (5.26%), 11(28.95%), 24 (63.16%) and 1 (2.63%) respectively. Hand E-stained sections showed that tumour-infiltrating lymphocytes (TILs) were present in 31 of the 38 carcinomas (81.58%). Majority of theTILs were T lymphocytes and was present in all 31 cases. CD4+ cells were seen31 patients and CD 8+ were seen in 25 cases. B cells were seen in 21 cases. TILs were analysed according to the clinical stage of breast cancer, stages III and IV tumors showed significantly higher densities of total lymphocytes, T lymphocytes, and CD4+ lymphocytes as compared to stage II tumors. Lymphocyte immuno phenotypes and the total TILs also showed a high significantly positive correlation between each lymphocyte population/subpopulation and the total TILs. Conclusion: T and B lymphocytes were expressed in breast carcinoma with High prevalence of T lymphocytes CD4+ cells. However larger no of cases are required to confirm the findings and extensive large studies are required.

Serum S-100B Protein as a Prognostic Marker in Malignant Cutaneous Melanoma

2001 ◽  
Vol 19 (3) ◽  
pp. 824-831 ◽  
Author(s):  
E. Djureen Mårtenson ◽  
L.O. Hansson ◽  
B. Nilsson ◽  
E. von Schoultz ◽  
E. Månsson Brahme ◽  
...  
Keyword(s):  
Malignant Melanoma ◽  
Prognostic Marker ◽  
Clinical Stage ◽  
Stage I ◽  
Stage Iii ◽  
Prognostic Impact ◽  
Independent Prognostic Marker ◽  
Protein Levels ◽  
Clinical Stages ◽  
Significant Independent Prognostic Factor

PURPOSE: To evaluate whether S-100B protein in serum is an independent prognostic marker in malignant melanoma. MATERIALS AND METHODS: S-100B protein in serum was analyzed in 1,007 consecutive patients with histologically verified cutaneous malignant melanoma. At the time of blood sampling, 876 patients were in clinical stage I, 35 were in stage II, and 96 were in stage III. The serum concentrations of S-100B protein were measured by a luminescence immunoassay (LIA). RESULTS: The mean serum concentration of S-100B protein was significantly related to clinical stage, with the lowest level in stage I and the highest in stage III. In a multivariate analysis, S-100B protein levels in serum showed the strongest prognostic impact of the factors analyzed with respect to disease-specific survival in clinical stages II to III, followed by clinical stage. Serum S-100B protein was not a significant independent prognostic factor in clinical stage I, where tumor thickness showed the strongest relation to melanoma-specific survival, followed by ulceration and satellites. CONCLUSION: This investigation contains the largest material of patients so far analyzed with the new LIA assay of S-100B protein in serum and confirms that S-100B protein in serum is correlated with clinical stage and is an independent prognostic marker in clinical stages II and III.

scholarly journals Prognostic Impact of 18FDG-PET-CT Findings in Clinical Stage III and IIB Breast Cancer

2012 ◽  
Vol 104 (24) ◽  
pp. 1879-1887 ◽  
Author(s):  
D. Groheux ◽  
E. Hindie ◽  
M. Delord ◽  
S. Giacchetti ◽  
A.-s. Hamy ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Clinical Stage ◽  
Stage Iii ◽  
Prognostic Impact ◽  
Ct Findings ◽  
18Fdg Pet ◽  
Pet Ct

Identification of biomarkers and functional modules from genomic data in stage-wise breast cancer

2020 ◽  
Vol 15 ◽  
Author(s):  
Athira K ◽  
Vrinda C ◽  
Sunil Kumar P V ◽  
Gopakumar G
Keyword(s):  
Breast Cancer ◽  
Expression Patterns ◽  
Differential Expression Analysis ◽  
Predictive Biomarkers ◽  
Stage I ◽  
Stage Ii ◽  
Stage Iii ◽  
Functional Modules ◽  
Incidence And Mortality ◽  
Multiple Stages

Background: Breast cancer is the most common cancer in women across the world, with high incidence and mortality rates. Being a heterogeneous disease, gene expression profiling based analysis plays a significant role in understanding breast cancer. Since expression patterns of patients belonging to the same stage of breast cancer vary considerably, an integrated stage-wise analysis involving multiple samples is expected to give more comprehensive results and understanding of breast cancer. Objective: The objective of this study is to detect functionally significant modules from gene co-expression network of cancerous tissues and to extract prognostic genes related to multiple stages of breast cancer. Methods: To achieve this, a multiplex framework is modelled to map the multiple stages of breast cancer, which is followed by a modularity optimization method to identify functional modules from it. These functional modules are found to enrich many Gene Ontology terms significantly that are associated with cancer. Result and Discussion: predictive biomarkers are identified based on differential expression analysis of multiple stages of breast cancer. Conclusion: Our analysis identified 13 stage-I specific genes, 12 stage-II specific genes, and 42 stage-III specific genes that are significantly regulated and could be promising targets of breast cancer therapy. That apart, we could identify 29, 18 and 26 lncRNAs specific to stage I, stage II and stage III respectively.

scholarly journals Impact of the Number of Dissected Lymph Nodes on Survival for Gastric Cancer after Distal Subtotal Gastrectomy

2011 ◽  
Vol 2011 ◽  
pp. 1-7 ◽  
Author(s):  
Chang-Ming Huang ◽  
Jian-Xian Lin ◽  
Chao-Hui Zheng ◽  
Ping Li ◽  
Jian-Wei Xie ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Survival Rate ◽  
Lymph Nodes ◽  
Distal Gastrectomy ◽  
Stage I ◽  
Stage Ii ◽  
Stage Iii ◽  
Prognostic Impact ◽  
Term Survival

Objectives. To investigate the prognostic impact of the number of dissected lymph nodes (LNs) in gastric cancer after curative distal gastrectomy.Methods. The survival of 634 patients who underwent curative distal gastrectomy from 1995 to 2004 was retrieved. Long-term surgical outcomes and associations between the number of dissected LNs and the 5-year survival rate were investigated.Results. The number of dissected LNs was one of the most important prognostic indicators. Among patients with comparable T category, the larger the number of dissected LNs was, the better the survival would be (). The linear regression showed that a significant survival improvement based on increasing retrieved LNs for stage II, III and IV (). A cut-point analysis yields the greatest variance of survival rate difference at the levels of 15 LNs (stage I), 25 LNs (stage II) and 30 LNs (stage III).Conclusion. The number of dissected LNs is an independent prognostic factor for gastric cancer. To improve the long-term survival of patients with gastric cancer, removing at least 15 LNs for stage I, 25 LNs for stage II, and 30 LNs for stage III patients during curative distal gastrectomy is recommended.

Differing from diseased stage in melanoma, the olfactory receptor gene OR56A4 is expressed

2021 ◽  
Author(s):  
Bronte Morse ◽  
Kobi Decker
Keyword(s):  
Breast Cancer ◽  
Cancer Patients ◽  
Olfactory Receptor ◽  
Receptor Gene ◽  
Stage I ◽  
Stage Ii ◽  
Stage Iii ◽  
Olfactory Receptor Gene ◽  
Breast Cancer Patients ◽  
Receptor Family

We have compared the global profiles of 100 tumors in Stage I, II and III with two independently releasedmicroarray datasets in order to understand their transcriptional behaviors accompanying a progression in breastcancer (1, 2). The olfactive receptor, family 56, subfamily A, member 4 OR56A4, was discovered to have beenone of the genes with the most varied expression when comparing initial tumors in stage I, stage II, and stageIII of breast cancer patients. In the stage III tumors, OR56A4 expression in comparison to the stage I tumorswas lower.

scholarly journals Analysis of Radiation Therapy for the Control of Merkel Cell Carcinoma of the Head and Neck Based on 36 Cases and a Literature Review

2008 ◽  
Vol 87 (11) ◽  
pp. 634-643 ◽  
Author(s):  
Brian D. Lawenda ◽  
Michelle G. Arnold ◽  
Valerie A. Tokarz ◽  
Joshua R. Silverstein ◽  
Paul M. Busse ◽  
...  
Keyword(s):  
Radiation Therapy ◽  
Head And Neck ◽  
Local Control ◽  
Clinical Stage ◽  
Local Control Rate ◽  
Stage I ◽  
Stage Iii ◽  
Regional Control ◽  
Kaplan Meier ◽  
Significant Difference

Merkel cell carcinoma (MCC) is a rare and aggressive epidermal cancer. We conducted a retrospective study and literature review to investigate the impact that radiation therapy has on local, regional, and distant control as part of the oncologic management of MCC of the head and neck and to further elucidate the role of radiation therapy with regard to regional control for the clinically uninvolved neck. We reviewed all registered cases of head and neck MCC that had occurred at four institutions from January 1988 through December 2005. Treatment and outcomes data were collected on patients with American Joint Committee on Cancer stage I, II, and III tumors. Local, regional, and distant control rates were calculated by comparing variables with the Fisher exact test; Kaplan-Meier analysis was used to report actuarial control data. Stage I to III head and neck MCC was identified in 36 patients— 22 men and 14 women, aged 43 to 97 years (mean: 71.6) at diagnosis. Patients with stage I and II tumors were combined into one group, and their data were compared with those of patients with stage III tumors. Twenty-sixpatients(72%) had clinical stage I/II disease and 10 patients (28%) had clinical stage III disease. Median follow-up was 41 months for the stage I/II group and 19 months for the stage III group. Based on examination at final follow-up visits, local recurrence was seen in 7 of the 36 patients (19%), for a local control rate of 81 %. The 2-year actuarial local control rate for all stages of MCC was 83%; by treatment subgroup, the rates were 95% for those who had undergone radiation therapy to the primary site and 69%) for those who had not— a statistically significant difference(p = 0.020). Based on information obtained at final follow-ups, 10 of the 36 patients (28%) experienced a regional recurrence, for a regional control rate of 72%. The 2-year actuarial regional control rate among all patients was 70%; by subgroup, rates were 82%) for patients who had undergone regional node radiation therapy and 60% for those who had not— not a statistically significant difference (p = 0.225). Nine patients (25%) overall developed a distant metastasis, for a distant control rate of 75%. Salvage therapies included chemotherapy and/or radiation therapy to the metastatic site, but neither had any significant effect on survival. Regardless of treatment, the Kaplan-Meier survival curves leveled off at 30 months with 82% survival for the stage I/II group and at 19 months with 60% survival for the stage III group. We conclude that radiation therapy to the primary tumor site (either following resection or definitively) results in a local control rate of more than 90% in patients with head and neck MCC. We also found a trend toward improved regional control of the clinically negative neck with the addition of radiation therapy.

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