Does Long-Term Exposure to Gel-Filled Silicone Implants Increase the Risk of Relapse after Breast Cancer?

1998 ◽  
Vol 84 (5) ◽  
pp. 525-528 ◽  
Author(s):  
Jean-Yves Petit ◽  
Monique Lê ◽  
Mario Rietjens ◽  
Geneviève Contesso ◽  
Andrée Lehmann ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Breast Reconstruction ◽  
Proportional Hazards Model ◽  
Silicone Implants ◽  
Control Group ◽  
Second Primary ◽  
Increased Risk ◽  
Risk Of Cancer

Background An increased risk of cancer and autoimmune diseases associated with gel-filled silicone implants, debated by FDA experts since 1991, has given rise to a profusion of literature on the subject. However, such effects have not been adequately investigated in patients with breast cancer. In a previous report we compared 146 breast cancer patients with gel-filled silicone implants for breast reconstruction to 146 control patients in whom no reconstruction had been performed. The observed results were reassuring, as the evolution of the disease after 10 years was better in the reconstruction group than in the control group. We now report the end results of this study with a median follow-up of 13 years after the breast reconstruction (range, 10-20 years). Method The relative risks of detrimental events were estimated with Cox's Proportional Hazards Model, with stratification according to age at diagnosis. Results The risks of locoregional recurrences and distant metastasis were significantly lower in the BR group than in the control group. The risks of death, of a second breast cancer and of a second primary cancer at a site other than the breast were not significantly different between the two groups of patients. Conclusion Long-term follow-up of patients exposed to gel-filled silicone implants confirms the absence of detrimental effects after breast cancer. The power of our study is, however, below that required to detect a very slight increase in the risks studied.

Long-term outcome and psychiatric comorbidity of adolescent-onset anorexia nervosa

2019 ◽  
Vol 25 (1) ◽  
pp. 33-44 ◽  
Author(s):  
Susana Andrés-Pepiñá ◽  
Maria Teresa Plana ◽  
Itziar Flamarique ◽  
Sonia Romero ◽  
Roger Borràs ◽  
...  
Keyword(s):  
Anorexia Nervosa ◽  
Control Group ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Statistical Manual ◽  
Diagnostic And Statistical Manual ◽  
Increased Risk ◽  
A Current

Objective: To assess the outcome of adolescents with anorexia nervosa (AN) about 20 years after first treatment. Methods: Sixty-two women diagnosed with AN during adolescence were invited to participate. Of these 62 patients, 38 agreed to participate and were assessed with a battery of questionnaires and interviews. A control group of 30 women of similar age was also assessed. Results: Of the patients who completed the full assessment, 13 (34%) presented some degree of eating disorder (ED) at follow-up (10 (26%) met full Diagnostic and Statistical Manual of Mental Disorders (5th ed.; DSM-5) criteria for an ED and 3 (8%) showed partial remission of an ED). The remaining 25 (66%) patients had fully recovered from AN. The duration of untreated illness before admission was significantly associated with an increased risk of a current ED (odds ratio (OR) = 3.334 (1.3–8.7); p = .014). Of the patients who had recovered totally from their ED, 24% showed another psychiatric disorder. This percentage rose to 70% in patients with a current ED. Conclusion: Sixty-six percent of adolescents who completed the assessment achieved remission of their AN. Comorbidity was more common in the current ED group. The variable that best predicted complete remission was the number of years without treatment, showing the importance of detection and early intervention.

Breast Cancer in Young Women after Treatment with Irradiation for Hodgkin’s Lymphoma.

Blood ◽  
2006 ◽  
Vol 108 (11) ◽  
pp. 3333-3333
Author(s):  
Linda Lee ◽  
Melania Pintilie ◽  
David Hodgson ◽  
Michael Crump
Keyword(s):  
Breast Cancer ◽  
High Risk ◽  
Breast Density ◽  
Young Women ◽  
Cumulative Incidence ◽  
Breast Mri ◽  
Increased Risk

Abstract BACKGROUND: Women who are survivors of Hodgkin’s Lymphoma (HL) are at increased risk of developing breast cancer (BCa) as a long-term complication due to the use of extended field (mantle) irradiation (RT) of disease above the diaphragm. Many young women are at significantly increased risk of BCa prior to the age at which routine screening mammography is recommended for the general population. The sensitivity of mammography is lower in these women, in part due to increased breast tissue density characteristic of young pre-menopausal women. Currently, there is a paucity of information on the optimal screening modality and surveillance frequency for these women. METHODS: We reviewed the current BCa screening strategies used for this high risk group at our centre and described the incidence, method of detection, and characteristics of secondary BCas in a cohort of 115 women who received supradiaphragmatic RT for HL before age 30 between 1965 and 2000 at Princess Margaret Hospital (PMH) and who subsequently accepted long-term follow-up in a high-risk screening clinic. RESULTS: Median age at treatment was 22 (range 9–30). Radiation fields were mantle in 106 women, modified mantle in 6, and involved field in 3 (median dose delivered: 35 Gy, range 15–60). RT alone was used for 44 patients while 71 received combined modality therapy, of which 45 (65%) received MOPP. Treatment induced amenorrhea occurred in 15 women (median age 38); hormone replacement therapy was subsequently used by 9. Of the 107 women who participated in annual radiographic BCa screening, 95 were screened with mammogram alone, 1 with breast MRI alone, 8 with mammogram and MRI, and 3 with mammogram and ultrasound. Median age at first mammogram was 36; however, median age decreased with more recent year of HL diagnosis (age 40 for women diagnosed before 1985 compared to age 33 for women diagnosed after 1985, p<0.0001). Women with high breast density received MRI screening more often (p=0.02); however, breast density was not significantly associated with previous breast radiation dose or age at last follow-up. Twelve women were diagnosed with BCa in this cohort, following active breast surveillance for a median of 5 years (representing 584 person-years). The 20-year cumulative incidence of breast cancer was 10.9% (95% CI 5.3–18.8%) in this group of women. This was comparable to the 20-year cumulative incidence of breast cancer of 12% (95% CI 8–17%) in all 448 women with HL treated with supradiaphragmatic radiation before age 30 at PMH during the same time period. BCa occurred after a median of 17 years after treatment for HL (range 13–28). Median age at BCa diagnosis was 40 (range 31–51). Seven cancers were detected by physical exam (6 node-positive invasive BCas, 1 in-situ BCa) and 5 were detected on annual mammograms (1 node-positive invasive BCa, 4 in-situ BCas). CONCLUSIONS: Although women in the more recent treatment cohort are receiving their first mammogram at a younger age, the majority of BCas were still detected clinically, and these BCas had less favorable pathological characteristics. More frequent breast imaging should be considered in women who have had supradiaphragmatic RT for HL. Prospective evaluation of breast MRI as a screening strategy for HL survivors has been initiated at PMH in an effort to detect BCa at an earlier stage.

hTert, MMP1, Her2 expressions by preneoplastic lesions and breast cancer risk

2006 ◽  
Vol 24 (18_suppl) ◽  
pp. 10510-10510 ◽  
Author(s):  
J. Hernandez ◽  
M. Mathieu ◽  
E. Taranchon ◽  
M. Spielmann ◽  
S. Delaloge ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Develop Breast Cancer ◽  
Atypical Hyperplasia ◽  
Control Group ◽  
Preneoplastic Lesion ◽  
Preneoplastic Lesions ◽  
In Situ Carcinoma ◽  
Increased Risk

10510 Background: Although it is well established that preneoplastic lesions are associated with an increased risk of breast cancer, there is no available tool to identify which patients will develop breast cancer. Telomerase, matrix metalloprotease 1 (MMP1) and Her2 have all been involved in the early steps of carcinogenesis. In the present study, we have looked at whether the expression of hTert, MMP1 and her2 in preneoplastic lesions were associated with higher risk of breast cancer. Methods: hTert, MMP1 and Her2 expressions by preneoplastic lesions were determined by immunohistochemistry in 34 patients who have subsequently developed a breast cancer (cases), and in 32 patients who did not present breast cancer in the follow-up (control). Patients were matched for age, length of follow-up and type of preneoplastic lesion. The expression of the three biomarkers was compared in the two groups. The initially planned sample size of the study was 90 matched patients, but only 66 samples could be proceed for technical reasons. Results: Median age was 47 and 49 years old in patients with and without further cancer respectively. In the group of patients who subsequently developed breast cancer (cases), preneoplastic lesions consisted in lobular hyperplasia or lobular in situ carcinoma in 17 cases, ductal atypical hyperplasia in 12 cases and mixed lesions in 5 cases. In the control group, preneoplastic lesions consisted in lobular hyperplasia or lobular in situ carcinoma in 18 cases, ductal atypical hyperplasia in 12 cases, mixed lesions in 2 cases. The median interval between the diagnosis of preneoplastic lesion and the occurrence of breast cancer was 72 months (17–291). hTert was expressed in 8 (27%) and 2 (7%) assessable lesions in cases and controls respectively (p = 0.04). MMP1 was expressed in 21 (65%) and 22 (73%) assessable lesions in cases and control respectively (p = 0.49). Her2 was expressed in 6 preneoplastic lesions both in cases and controls (20%). Conclusions: This study suggests that hTert expression by preneoplastic lesions could be associated with an increased risk breast cancer. No significant financial relationships to disclose.

Second Primary Tumors in Neurofibromatosis 1 Patients Treated for Optic Glioma: Substantial Risks After Radiotherapy

2006 ◽  
Vol 24 (16) ◽  
pp. 2570-2575 ◽  
Author(s):  
Saba Sharif ◽  
Rosalie Ferner ◽  
Jillian M. Birch ◽  
James E. Gillespie ◽  
H. Rao Gattamaneni ◽  
...  
Keyword(s):  
Nervous System ◽  
Neurofibromatosis 1 ◽  
Optic Glioma ◽  
Second Primary ◽  
Primary Tumors ◽  
Nervous System Tumors ◽  
Increased Risk ◽  
Second Tumors

Purpose Optic pathway gliomas (OPGs) are the most common CNS tumor in neurofibromatosis 1 (NF1) patients. We evaluated the long-term risk of second tumors in NF1-related OPGs after radiotherapy. Patients and Methods We reviewed 80 NF1 OPG patients from two NF1 clinics to evaluate the long-term risk of developing subsequent nervous system tumors, with or without radiotherapy. Results Fifty-eight patients were assessable for second tumors. Nine (50%) of 18 patients who received radiotherapy after their OPGs developed 12 second tumors in 308 person-years of follow-up after radiotherapy. Eight (20%) of 40 patients who were not treated with radiotherapy developed nine tumors in 721 person-years of follow-up after diagnosis of their OPGs. The relative risk of second nervous system tumor after radiotherapy was 3.04 (95% CI, 1.29 to 7.15). Conclusion There is a significantly increased risk of second nervous system tumors in those NF1 patients who received radiotherapy for their OPGs, especially when treated in childhood. Thus radiotherapy should only be used if absolutely essential in children with NF1.

Risk of cancer among sarcoidosis patients with biopsy-verified non-necrotizing granulomatous inflammation: Population-based cohort study

2021 ◽  
pp. jrheum.210588
Author(s):  
Mikkel Faurschou ◽  
Lars H. Omland ◽  
Niels Obel ◽  
Jesper Lindhardsen ◽  
Bo Baslund
Keyword(s):  
Solid Tumors ◽  
Granulomatous Inflammation ◽  
Population Based ◽  
Risk Difference ◽  
Increased Risk ◽  
Incidence Functions ◽  
Risk Of Cancer ◽  
Population Controls

Objective To assess the long-term risk of hematologic cancers, invasive solid tumors, and nonmelanoma skin cancer (NMSC) among sarcoidosis patients with biopsy-verified non-necrotizing granulomatous inflammation. Methods We used Danish administrative registers with nationwide coverage to construct a cohort of 3892 sarcoidosis patients and an age- and gender-matched comparison cohort of 38.920 population-controls. For all patients, a biopsy demonstrating non-necrotizing granulomatous inflammation had been obtained from the lower respiratory tract at time of diagnosis. Study outcome was time to diagnosis of cancer. Follow-up began at time of sarcoidosis diagnosis and continued for up to 10 years. We calculated hazard ratios (HRs) as estimates of the cancer risk among the sarcoidosis patients relative to that among the population-controls and used cumulative incidence functions to calculate absolute 10-year risk estimates. Results We observed an increased long-term risk of hematologic cancers (HR during the first 2 years of follow-up: 2.71 (95% CI: 1.18-6.25); HR after >2 years of follow-up: 2.12 (95% CI: 1.29-3.47)) and NMSC (HR after >2 years of follow-up: 1.82 (95% CI: 1.43-2.32)) among the sarcoidosis patients. An increased risk of invasive solid tumors was only observed during the first 2 years (HR: 1.55 (95% CI: 1.18-2.04)). Compared with the population-controls, the sarcoidosis patients had an increased absolute 10-year risk of hematologic cancers (risk difference: 0.56% (95% CI: 0.11%-1.01%)) and NMSC (risk difference: 1.58% (95% CI: 0.70%-2.47%)). Conclusion Sarcoidosis patients with biopsy-verified non-necrotizing granulomatous inflammation have an increased long-term risk of hematologic cancers and NMSC compared with the general population.

scholarly journals Long-term outcome of patients with invasive electrophysiology procedure-related cardiac tamponade

EP Europace ◽  
2020 ◽  
Vol 22 (10) ◽  
pp. 1547-1557
Author(s):  
Gesa von Olshausen ◽  
Tara Bourke ◽  
Jonas Schwieler ◽  
Nikola Drca ◽  
Hamid Bastani ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Heart Failure ◽  
Acute Myocardial Infarction ◽  
Cardiac Tamponade ◽  
Cardiovascular Events ◽  
Control Group ◽  
Risk Of Death ◽  
Increased Risk

Abstract Aims Iatrogenic cardiac tamponades are a rare but dreaded complication of invasive electrophysiology procedures (EPs). Their long-term impact on clinical outcomes is unknown. This study analysed the risk of death or serious cardiovascular events in patients suffering from EP-related cardiac tamponade requiring pericardiocentesis during long-term follow-up. Methods and results Out of 19 997 invasive EPs at the Karolinska University Hospital between January 1998 and September 2018, all patients with EP-related periprocedural cardiac tamponade were identified (n = 60) and matched (1:3 ratio) to a control group (n = 180). After a follow-up of 5 years, the composite primary endpoint — death from any cause, acute myocardial infarction, transitory ischaemic attack (TIA)/stroke, and hospitalization for heart failure — occurred in significantly more patients in the tamponade than in the control group [12 patients (20.0%) vs. 19 patients (10.6%); hazard ratio (HR) 2.53 (95% confidence interval, CI 1.15–5.58); P = 0.021]. This was mainly driven by a higher incidence of TIA/stroke in the tamponade than in the control group [HR 3.75 (95% CI 1.01–13.97); P = 0.049]. Death from any cause, acute myocardial infarction, and hospitalization for heart failure did not show a significant difference between the groups. Hospitalization for pericarditis occurred in significantly more patients in the tamponade than in the control group [HR 36.0 (95% CI 4.68–276.86); P = 0.001]. Conclusion Patients with EP-related cardiac tamponade are at higher risk for cerebrovascular events during the first 2 weeks and hospitalization for pericarditis during the first months after index procedure. Despite the increased risk for early complications tamponade patients have a good long-term prognosis without increased risk for mortality or other serious cardiovascular events.

Long-Term Cause-Specific Mortality of Patients Treated for Hodgkin’s Disease

2003 ◽  
Vol 21 (18) ◽  
pp. 3431-3439 ◽  
Author(s):  
Berthe M.P. Aleman ◽  
Alexandra W. van den Belt-Dusebout ◽  
Willem J. Klokman ◽  
Mars B. van’t Veer ◽  
Harry Bartelink ◽  
...  
Keyword(s):  
General Population ◽  
Hodgkin's Disease ◽  
Hodgkin’S Disease ◽  
Initial Therapy ◽  
Second Primary ◽  
Risk Of Death ◽  
Increased Risk ◽  
Specific Mortality

Purpose: To assess long-term cause-specific mortality of young Hodgkin’s disease (HD) patients. Patients and Methods: The study population consisted of 1,261 patients treated for HD before age 41 between 1965 and 1987. Follow-up was complete until October 2000. For 95% of deaths, the cause was known. Long-term cause-specific mortality was compared with general population rates to assess relative risk (RR) and absolute excess risk (AER) of death. Results: After a median follow-up of 17.8 years, 534 patients had died (55% of HD). The RR of death from all causes other than HD was 6.8 times that of the general population, and still amounted to 5.1 after more than 30 years. RRs of death resulting from solid tumors (STs) and cardiovascular disease (CVD) were increased overall (RR = 6.6 and 6.3, respectively), but especially in patients treated before age 21 (RR = 14.8 and 13.6, respectively). When these patients grew older, this elevated mortality decreased. The overall AER of death from causes other than HD increased throughout follow-up. Patients receiving salvage chemotherapy had a significantly increased RR of death from STs, compared to patients receiving initial therapy only. Conclusion: The main cause of death among HD patients was lymphoma, but after 20 years, HD mortality was negligible. The RRs and AERs of death from second primary cancers (SCs) and CVDs continued to increase after 10 years. Even more than 30 years after diagnosis, HD patients experienced elevated risk of death from all causes other than HD. Increased risk of death from SCs and CVDs was found especially in patients treated before age 21, but these risks seemed to abate with age.

scholarly journals Pathological Significance of GLUT-1 Expression in Breast Cancer Cells in Diabetic and Obese Patients: The French Guiana Study

Cancers ◽  
2022 ◽  
Vol 14 (2) ◽  
pp. 437
Author(s):  
Valentin Suteau ◽  
John Bukasa-Kakamba ◽  
Beatrice Virjogh-Cenciu ◽  
Antoine Adenis ◽  
Nadia Sabbah ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Tumor Size ◽  
French Guiana ◽  
Proliferation Index ◽  
Control Group ◽  
Obese Patients ◽  
Glucose Transporter 1 ◽  
Glut 1 ◽  
Increased Risk ◽  
Risk Of Cancer

The prevalence of obesity and type 2 diabetes is higher in French Guiana compared to mainland France. These metabolic disorders are associated with an increased risk of cancer. One of the factors involved is hyperinsulinemia that promotes the action of glucose transporter 1 (GLUT-1). The objective of this study is to characterize the expression of GLUT-1 in breast cancers cells in diabetic and obese patients compared to those who are not and to describe the clinical and histological prognostic factors of breast cancer in this population. We conducted a monocentric study including patients with breast cancer diagnosed between 2014 and 2020. Patients were classified into three groups: diabetes, obesity, and control group. The GLUT-1 expression was assessed by immunohistochemistry. In total, 199 patients were included in this study. The median age was 53.5 years, and the median tumor size was 2.8 cm. Luminal A was the most frequent molecular type (58.1%), followed by the triple-negative type (19.9%). The breast cancer in our population was characterized by a younger age at diagnosis, more aggressive molecular types, and larger tumor size. Thus, we suggest the advancement of the age of breast cancer screening in this territory. A total of 144 patients (31 diabetes, 22 obese, and 91 control group) were included for the study of GLUT-1 expression. Overexpression of GLUT-1 was observed in 60.4% of cases and in all carcinoma in situ lesions. GLUT-1 overexpression was associated with more aggressive cancers. This overexpression is correlated with high histological grade, high proliferation index, and aggressive molecular types. Our study found no difference in GLUT-1 expression between the diabetic or obese patients and the control group. These results highlight the potential role of GLUT-1 as a tumor metabolic prognostic marker and also as an interesting target therapy, independently of patient metabolic disorder.

scholarly journals Matched-Pair Long-Term Survival Analysis of Male and Female Patients with Breast Cancer: A Population-Based Study

2021 ◽  
Author(s):  
Xiaoshuang Feng ◽  
Miao Mo ◽  
Chunxiao Wu ◽  
Yangming Gong ◽  
Changming Zhou ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Survival Rates ◽  
Matched Pair ◽  
Term Survival ◽  
Male And Female ◽  
Long Term Survival ◽  
Female Patients ◽  
Increased Risk ◽  
Risk Of Cancer

Abstract Purpose: To examine the differences in long-term survival between male and matched female breast cancer cases based on data from the Shanghai Cancer Registry (SCR).Methods: Every male breast cancer case was matched with four female cases according to the year of diagnosis, age, tumor stage, and histological subtype. Cumulative observed overall survival (OS) and cancer-specific survival (CSS) rates were calculated using Kaplan-Meier survival estimates, and log-rank tests were applied to compare the survival rates of male and female cases. Cox proportional-hazards regression models were used to assess the hazard ratios (HR) and 95% confidence intervals (CI) for the association between sex and the risk of death.Results: 50,958 patients with breast cancer (0.85% male) were registered in the SCR between 2002 and 2013. After matching, 434 male and 1736 female patients were included in the study. With a median follow-up time of 10 years, men with breast cancer showed significantly worse OS (P < 0.0001) and CSS (P < 0.0001) than women. The 5- and 10-year OS rates for male and female patients were 67.27% and 77.75%, and 45.95% and 62.60%, respectively; the 5- and 10-year CSS rates for male and female patients were 70.19% and 79.79%, and 50.57% and 67.20%, respectively. Compared with women, men had 65% increased risk of overall death (95% CI: 1.42-1.92) and 70% increased risk of cancer-specific death (95% CI: 1.44-2.00).Conclusion: The study provided evidence at the population level that male patients with breast cancer had lower survival rates than women in China.

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