High Levels of Cathepsin B Predict Poor Outcome in Patients with Breast Cancer

1998 ◽  
Vol 13 (3) ◽  
pp. 139-144 ◽  
Author(s):  
T.M. Maguire ◽  
S.G Shering ◽  
C.M. Duggan ◽  
E.W. McDermott ◽  
N.J. O'Higgins ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Multivariate Analysis ◽  
Plasminogen Activator ◽  
Tumor Size ◽  
Cathepsin B ◽  
Nodal Status ◽  
Chi Square ◽  
Poor Outcome ◽  
Cancer Spread ◽  
Er Status

Cathepsin B (CB) is a thiol-stimulated protease implicated in cancer invasion and metastasis. Other proteases involved in cancer spread such as urokinase-type plasminogen activator (uPA) and cathepsin D have previously been shown to be prognostic markers in breast cancer. CB was assayed by ELISA in 193 patients with primary breast cancer. CB levels were significantly higher in both primary and metastatic breast tumors than in fibroadenomas (p=0.0001). In the primary carcinomas, CB levels showed no significant correlation with either nodal status, tumor size or estrogen receptor (ER) status. Patients with primary breast cancers containing high levels of CB had a significantly shorter disease-free interval (p=0.01, chi-square=6.61) and overall survival (p=0.014, chi-square=6.08) than patients with low levels of the protease. However, in multivariate analysis, using nodal status, tumor size, ER status and urokinase plasminogen activator (uPA), CB was not an independent prognostic marker. In contrast, nodal status, ER status and uPA were prognostic in multivariate analysis. In conclusion, CB, like certain other proteases implicated in cancer metastasis, correlates with poor outcome in patients with breast cancer. These results thus support the evidence from model systems linking CB to cancer spread. Inhibition of CB expression or activity might therefore be exploited for anti-metastatic therapies.

CA 15–3: A Prognostic Marker in Breast Cancer

2000 ◽  
Vol 15 (4) ◽  
pp. 330-333 ◽  
Author(s):  
M.J. Duffy ◽  
S. Shering ◽  
F. Sherry ◽  
E. McDermott ◽  
N. O'Higgins
Keyword(s):  
Breast Cancer ◽  
Multivariate Analysis ◽  
Prognostic Marker ◽  
Tumor Size ◽  
Recurrent Breast Cancer ◽  
Serum Marker ◽  
Nodal Status ◽  
Prognostic Impact ◽  
Transmembrane Glycoprotein ◽  
A Prospective Study

CA 15–3 (also known as MUC1) is the most widely used serum marker in breast cancer. MUC1 is a large transmembrane glycoprotein which is frequently overexpressed and aberrantly glycosylated in cancer. Physiologically, MUC1 appears to play a role in cell adhesion and the high levels present in cancer may be causally involved in metastasis. At present the main uses of CA 15–3 are in preclinically detecting recurrent breast cancer and monitoring the treatment of patients with advanced breast cancer. In a prospective study of 368 patients we show that patients with high preoperative levels of CA 15–3 (>30.4 U/mL) had a worse outcome than patients with low levels of the marker. In multivariate analysis CA 15–3 as a prognostic marker was independent of both tumor size and nodal status. Furthermore, in multivariate analysis the prognostic impact of CA 15–3 was stronger than that of tumor size and at least as strong as nodal status. CA 15–3 may thus be the first independent prognostic serum marker in breast cancer.

Histologic Grade Remains a Prognostic Factor for Breast Cancer Regardless of the Number of Positive Lymph Nodes and Tumor Size: A Study of 161 708 Cases of Breast Cancer From the SEER Program

2014 ◽  
Vol 138 (8) ◽  
pp. 1048-1052 ◽  
Author(s):  
Arnold M. Schwartz ◽  
Donald Earl Henson ◽  
Dechang Chen ◽  
Sivasankari Rajamarthandan
Keyword(s):  
Breast Cancer ◽  
Prognostic Factor ◽  
Lymph Nodes ◽  
Tumor Size ◽  
Nodal Status ◽  
Histologic Grade ◽  
Axillary Lymph Nodes ◽  
Low Grade ◽  
Axillary Lymph ◽  
Data Set

Context.—The appropriate staging of breast cancers includes an evaluation of tumor size and nodal status. Histologic grade in breast cancer, though important and assessed for all tumors, is not integrated within tumor staging. Objective.—To determine whether the histologic grade remains a prognostic factor for breast cancer regardless of tumor size and the number of involved axillary lymph nodes. Design.—By using a new clustering algorithm, the 10-year survival for every combination of T, N, and the histologic grade was determined for cases of breast cancer obtained from the Surveillance, Epidemiology, and End Results Program of the National Cancer Institute. There were 36 combinations of TN, defined according to the American Joint Committee on Cancer, and grade. Results.—For each combination of T and N, a categorical increase in the histologic grade was associated with a progressive decrease in 10-year survival regardless of the number of involved axillary lymph nodes or size of the primary tumor. Absolute survival differences between high and low grade persisted despite larger tumor sizes and greater nodal involvement, though trends were apparent with increasing breast cancer stage. Statistical significance depended on the number of cases for each combination. Conclusions.—Histologic grade continues to be of prognostic importance for overall survival despite tumor size and nodal status. Furthermore, these results seem to indicate that the assignment of the histologic grade has been consistent among pathologists when evaluated in a large data set of patients with breast cancer. The incorporation of histologic grade in TNM staging for breast cancer provides important prognostic information.

Relationship between tumor size and metastatic site in patients with stage IV breast cancer: A large SEER-based study.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. e13065-e13065
Author(s):  
Qian Dong ◽  
Mi Zhang ◽  
Da Jiang
Keyword(s):  
Breast Cancer ◽  
Cancer Patients ◽  
Tumor Size ◽  
Stage Iv ◽  
Breast Cancer Patients ◽  
Luminal A ◽  
Chi Square ◽  
Metastatic Site ◽  
Luminal B ◽  
Stage Iv Breast Cancer

e13065 Background: To analyze the correlation between tumor size and metastatic site in first-diagnosed stage IV breast cancer patients. Methods: Stage IV breast cancer patients diagnosed from 2010 to 2015 were screened by the Surveillance, Epidemiology, and End Results (SEER) database. The characteristics of clinical variables were represented by a frequency table, and the Chi-square test was used for comparison. At the same time, the Chi-square test was used to analyze the relationship between tumor size and organ metastasis. Correlation between tumor size and the prognosis of patients was contributed by KM curve and Log-rank test. Results: Regardless of tumor size, the proportion of bone metastasis was higher and brain metastasis was lower in breast cancer patients. There were significant differences in the site of metastases based on different subtype. Luminal A and Luminal B breast cancer had the highest proportion of bone metastases; brain metastasis accounted for the highest proportion in triple-negative breast cancer (TNBC); while the incidence of liver metastasis was the highest in Her-2(+) breast cancer. At the same time, the results indicated that Luminal A breast cancer with a tumor size > 5 cm was more likely to develop multi-site metastasis and lung metastasis, while Luminal B breast cancer with a tumor size ≤ 5 cm was more likely to develop liver metastasis. The results also revealed that TNBC patients with a tumor size of 0 - 2cm were more likely to develop bone metastasis than those with a tumor size > 5 cm, and the incidence of lung metastasis in triple-negative patients showed an increasing trend with the increase of tumor size. Conclusions: Based on subtype, we found that there was a significant difference between tumor size and metastatic site in patients with stage IV breast cancer, and the difference was statistically significant. This study provided evidence-based basis for decision-making of stage IV breast cancer treatment.

scholarly journals PO-0739: Role of ki67, tumor size and lymph nodal status as a prognostic index in breast cancer

2018 ◽  
Vol 127 ◽  
pp. S378-S379
Author(s):  
F. Arcadipane ◽  
S. Osella-Abate ◽  
A. Vella ◽  
P. Franco ◽  
S. Martini ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Tumor Size ◽  
Prognostic Index ◽  
Nodal Status

Cathepsin B, Cathepsin H, Cathepsin X and Cystatin C in Sera of Patients with Early-Stage and Inflammatory Breast Cancer

2008 ◽  
Vol 23 (3) ◽  
pp. 161-168 ◽  
Author(s):  
J. Decock ◽  
N. Obermajer ◽  
S. Vozelj ◽  
W. Hendrickx ◽  
R. Paridaens ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cystatin C ◽  
Inflammatory Breast Cancer ◽  
Tumor Size ◽  
Cathepsin B ◽  
Early Stage ◽  
Menopausal Status ◽  
Preoperative Serum ◽  
Cathepsin H ◽  
Cathepsin X

Numerous studies have linked cathepsins and their inhibitor cystatin C to tumor invasion and metastasis. We examined whether cathepsin B, cathepsin H, cathepsin X and cystatin C could be detected in sera from women with early-stage or inflammatory breast cancer and whether they correlated with clinicopathological characteristics. Preoperative serum was obtained from 176 patients with early-stage breast cancer (tumor size <5 cm, negative lymph nodes) and 31 patients with inflammatory breast cancer. Cathepsin and cystatin C levels were measured by ELISA. The patient and tumor characteristics under study were age at diagnosis, menopausal status, tumor size, tumor grade, and steroid hormone receptor status. Serum cathepsin B levels were significantly lower in patients with poorly differentiated tumors. High cystatin C levels were associated with tumor size, postmenopausal status and patient age. Interestingly, significantly lower levels of cathepsin X and H were found in patients with inflammatory breast cancer, a trend also observed for cathepsin B and cystatin C. In conclusion, our results show a limited association of cathepsins B, H, X and cystatin C with established prognostic parameters. These data are promising and encourage future analysis of the clinical outcome of our patients in order to examine the potential prognostic value of these biomarkers. Further, this study indicates a role for cathepsin X and H in inflammatory breast cancer.

Clinical significance of HER-2/neu oncogene amplification in primary breast cancer. The South Australian Breast Cancer Study Group.

1993 ◽  
Vol 11 (10) ◽  
pp. 1936-1942 ◽  
Author(s):  
R Seshadri ◽  
F A Firgaira ◽  
D J Horsfall ◽  
K McCaul ◽  
V Setlur ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Multivariate Analysis ◽  
Tumor Size ◽  
Copy Number ◽  
Node Negative ◽  
Node Positive ◽  
Oncogene Amplification ◽  
Her 2 ◽  
Neu Oncogene

PURPOSE To determine prospectively the prognostic significance of HER-2/neu oncogene amplification in the primary tumors of breast cancer patients. METHODS HER-2/neu amplification in tumor DNA was determined by the slot-blot technique in 1,056 patients with breast cancer (stage I to III) diagnosed between 1987 and 1990. Parameters such as estrogen receptor (ER) and progesterone receptor (PgR) levels, tumor size, axillary nodal involvement, tumor grade, and time to relapse were prospectively obtained. RESULTS HER-2/neu oncogene amplification, > or = 2, > or = 3, and > or = 5 copy number, was detected in 21%, 11%, and 7% of patients, respectively. In a test set of 529 patients, Cox multivariate analysis showed HER-2/neu copy number > or = 3 or > or = 5 was associated with shorter disease-free survival (DFS) duration. HER-2/neu copy number > or = 3 correlated significantly with pathologic stage of disease, number of axillary nodes with tumor, histologic type, and absence of ER and PgR. For all patients, after a median follow-up duration of 39 months, Kaplan-Meier univariate analysis indicated that tumor oncogene copy number > or = 3 correlated with shorter DFS in both node-negative and node-positive patients. In Cox multivariate analysis, HER-2/neu copy number > or = 3 was associated with shorter DFS, independent of nodal status, ER level, and tumor size. CONCLUSION Although the follow-up duration of this study is relatively short, we conclude that HER-2/neu amplification is an independent predictor of shorter DFS in both node-negative and node-positive patients.

scholarly journals The Numbers of FoxP3+ Lymphocytes in Sentinel Lymph Nodes of Breast Cancer Patients Correlate With Primary Tumor Size but Not Nodal Status

2011 ◽  
Vol 29 (6) ◽  
pp. 419-425 ◽  
Author(s):  
Raavi Gupta ◽  
James S. Babb ◽  
Baljit Singh ◽  
Luis Chiriboga ◽  
Leonard Liebes ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Lymph Nodes ◽  
Cancer Patients ◽  
Tumor Size ◽  
Primary Tumor ◽  
Sentinel Lymph Nodes ◽  
Nodal Status ◽  
Breast Cancer Patients ◽  
Primary Tumor Size

Late relapse associated with CEP 17 polysomic breast cancer

2006 ◽  
Vol 24 (18_suppl) ◽  
pp. 20011-20011
Author(s):  
L. J. Theobald ◽  
S. Dobin ◽  
S. Beeran ◽  
D. Miltenburg ◽  
H. Rajab ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Gene Amplification ◽  
Tumor Size ◽  
Nodal Status ◽  
Gene Copy ◽  
Categorical Variables ◽  
Late Relapse ◽  
Study Cohort ◽  
Breast Cancers ◽  
Clinicopathologic Factor

20011 Background: The clinicopathologic features associated with chromosome enumeration probe 17 (CEP 17) polysomy by fluorescence in situ hybridization (FISH) are not well defined. CEP 17 polysomy is frequently encountered in assessing Her-2neu amplification, which has become an important adjuvant therapeutic target. One mechanism to increase Her-2neu gene copy is polysomy. In this analysis the prognostic and predictive factors associated with CEP 17 polysomy are compared to similar factors in Her-2neu gene amplification. Methods: All cases of Her-2neu gene amplification and CEP 17 polysomic breast cancers from 2000 to present were abstracted. The polysomy group was defined as at least 3 gene copies and was further subdivided into two groups; 3–4 copies and ≥ 5 copies. This resulted in 193 cases of invasive breast cancer, which became the study cohort. Polysomic status and her-2neu gene amplification was compared to age, estrogen receptor (ER), progesterone receptor (PR), grade, tumor size, cell type, mitotic rate, nodal status, number of positive nodes and relapse. Descriptive statistics were used for categorical variables. The χ2 test was used to compare each clinicopathologic factor. Results: Both the ER and PR status was significantly different in the 3 groups. For the Her-2neu amplified, the polysomic 3–4, and the polysomic ≥ 5, the ER positive status was 53%, 67% and 81%, respectively (p = .012). Histologic grade, tumor size and nodal status were not significantly different between groups. Lobular pathology was present in 15% of the polysomy ≥ 5 group, 8% of the polysomy 3–4 group and 1.7% of the amplified group and this difference was significant (p = .03). Relapse disease status was significantly more frequent in the polysomy ≥ 5 group (18.5%) compared to the amplified group (2.6%) (p = .007). Within the relapsed group the median time to relapse was 4 years for the amplified patients versus 12 years and 10 years for the polysomic patients. Conclusion: The incidence of CEP 17 polysomy varies in the literature from 10–50% depending on definitions. Our study is unique in that we divided the polysomic group into 3–4 copies which can be complicated by proliferative activity versus ≥ 5 copies. A significant association between relapse and polysomic breast cancer is described in our dataset. No significant financial relationships to disclose.

Mammography use in women age 80 and older with breast cancer

2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 9039-9039
Author(s):  
S. H. Giordano ◽  
B. Badgwell ◽  
Z. Duan ◽  
I. Bedrosian ◽  
G. Hortobagyi ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Multivariate Analysis ◽  
Health Care Providers ◽  
Tumor Size ◽  
Age Groups ◽  
Breast Cancer Diagnosis ◽  
Screening Mammography ◽  
Stage Ii ◽  
Care Providers ◽  
Mammography Use

9039 Background: The guidelines for screening mammography use in patients age 80 years and older are not clear. The purpose of this study was to determine the effect of mammography use on stage and tumor size at breast cancer diagnosis. Methods: The study is a retrospective cohort using the Surveillance, Epidemiology, and End Results (SEER)-Medicare linked database. We evaluated 14,976 women aged 80 and older diagnosed with breast cancer between 1996–2002. Patients were divided into three cohorts based on screening mammography use in the 60 months prior to diagnosis: nonusers, non-regular users (1–2 mammograms), and regular users (3+). The effects of screening on tumor stage (0-I vs. II-IV) and size were determined by logistic regression and multivariate analysis of variance. Results: Regular mammography use for the age groups 80–84, 85–89, and >= 90 was 29%, 19%, and 9%, respectively. Among regular users of mammography, 26% presented with stage II or greater cancer while 64% of non-users presented with stage II or greater disease. On multivariate analysis, non-users were 4.7 (95% CI 4.26–5.14) times more likely to present with high-stage cancer. Non-users, non-regular users, and regular users had an adjusted mean tumor size of 5.08 (4.44–5.72), 3.26 (2.57–3.95), and 2.77 (2.02–3.51), respectively. Conclusions: Regular screening mammography among women aged 80 years and older is associated with earlier stage at presentation and smaller tumor size compared to mammography nonusers. Health care providers should consider discussing potential benefits of screening mammography with their older patients particularly for those without significant comorbidity. No significant financial relationships to disclose.

Behavior of breast cancer in young women: A Surveillance Epidemiology and End Results (SEER) database review.

2012 ◽  
Vol 30 (27_suppl) ◽  
pp. 6-6
Author(s):  
Anteneh A. Tesfaye ◽  
Mohammad Mozayen ◽  
Ioana Morariu ◽  
David S. Eilender
Keyword(s):  
Breast Cancer ◽  
Lymph Nodes ◽  
Young Women ◽  
Tumor Size ◽  
Hormone Receptor ◽  
Age Groups ◽  
Tumor Grade ◽  
Seer Database ◽  
Chi Square ◽  
Cancer Specific Survival

6 Background: Advanced age is a major risk factor for breast cancer in women. Small sized studies have reported variable outcome of breast cancer in young women. Our study was done to evaluate tumor characteristic and cancer specific survival among young women. Methods: The 1973-2009 SEER database was reviewed for women with breast cancer diagnosed between 2004 and 2009. Patients were grouped by age into: A (≤35 years), B (36-50 years) and C (>50 years). Age, ethnicity, staging, lymph nodes status, micrometastasis in negative lymph nodes, tumor size, tumor grade, hormone receptor status were extracted. Data and survival were analyzed using chi square, Kaplan-Meier, Life table, and Cox proportional hazard model. The primary outcome was 5-year cancer-specific survival. Results: A total of 248,280 patients were included in the study, group A, B and C making 2.8%, 25.5% and 71.7% of study subjects respectively. The median tumor size was 2.4, 1.9, and 1.6 cm in groups A, B and C respectively (p=0.0001). Positive lymph nodes were seen in 52.5%, 43% and 34% in groups A, B and C respectively (p=0.0001). Regional disease was seen in 47.5%, 39.5% and 29.9% in groups A, B and C respectively (p=0.0001). Higher Grade histology was seen in 63.5%, 44.3% and 33.8% in groups A, B and C respectively (p=0.0001). ER-PR negative were found in 42.1%,26.4%, 22.6% of Groups A, B and C respectively (p=0.0001). Five year cancer specific survival was 82%, 89%, 86% in groups A, B and C respectively (p=0.0001). Independent prognostic factors are given in the table. Conclusions: Breast cancer is uncommon among young women (age <35). Compared to other age groups, breast cancer in young women presents with bigger tumor, higher nodal positivity, an advanced stage, higher tumor grade, higher hormone receptor negativity, and worse 5-year cancer-specific survival. [Table: see text]

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