CYP2D6 gene variants: association with breast cancer specific survival in a cohort of breast cancer patients from the United Kingdom treated with adjuvant tamoxifen

e11062 Background: Inflammatory breast cancer (IBC) is an aggressive form of locally advanced breast cancer characterised by rapidly progressive breast erythema, pain and tenderness, oedema and paeu d’orange. It is estimated that between 1-4 % of all newly diagnosed breast cancer patients in the United Kingdom have IBC. Methods: We retrospectively identified 51 patients who were treated for IBC at 7 hospitals in the West midlands area of the United Kingdom between 1997 and 2011. Data including patients’ demographics, clinical, radiological and histopathological characteristics were collected from electronic clinical records. The test for HER-2 over-expression was not carried out routinely before 2002, therefore HER-2 status of such patients were assessed retrospectively on the archived tissues. A cox regression analysis was used for statistical assessment of survival and prognostic factors. Results: Median age at diagnosis was 55 years (range 34-83 yrs). Median overall (OS) and progression free survival (PFS) were 32 months (range 7-97 months) and 27 months (range 2-53 months) respectively. The 3–year survival rate for the entire cohort was 32%. Majority of patients were ER and HER-2 positive (49% and 52% respectively). The rate of complete pathological response (pCR) after neoadjuvant chemotherapy was 14%. All cases who had achieved pCR were HER-2 positive who had received anti HER-2 treatment during the neoadjuvant chemotherapy. The OS for the HER-2 positive patients with pCR was not statistically different from the whole cohort (49 vs 32 months, p=0.09) or from the patients with residual disease (49 vs 26 months, p=0.13). Although the triple negative IBC patients consisted 20% of the cohort, no patients in this group had achieved pCR. The OS and PFS for the triple negative patients were 20 and 14 months respectively. Although the rate of pCR was higher in patients treated with taxane compared to those treated with anthracycline containing chemotherapy (35% vs 7%), there was no significant difference in OS between either of these regimens (29 vs 27 months). Conclusions: HER-2 positive IBC patients had higher rate of achieving pCR after neo-adjuvant anti HER-2 therapy. However higher rate of pCR did not improve the OS.

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Ethnicity and outcome of young breast cancer patients in the United Kingdom: the POSH study

British Journal of Cancer ◽

10.1038/bjc.2013.650 ◽

2013 ◽

Vol 110 (1) ◽

pp. 230-241 ◽

Cited By ~ 31

Author(s):

E Copson ◽

◽

T Maishman ◽

S Gerty ◽

B Eccles ◽

...

Keyword(s):

Breast Cancer ◽

United Kingdom ◽

Cancer Patients ◽

Breast Cancer Patients ◽

The United Kingdom ◽

Young Breast Cancer

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The Extent of Axillary Surgery Is Associated With Breast Cancer-specific Survival in T1–2 Breast Cancer Patients With 1 or 2 Positive Lymph Nodes

Medicine ◽

10.1097/md.0000000000003254 ◽

2016 ◽

Vol 95 (14) ◽

pp. e3254 ◽

Cited By ~ 3

Author(s):

Shunrong Li ◽

Fengtao Liu ◽

Kai Chen ◽

Nanyan Rao ◽

Yufen Xie ◽

...

Keyword(s):

Breast Cancer ◽

Lymph Nodes ◽

Cancer Patients ◽

Breast Cancer Specific Survival ◽

Breast Cancer Patients ◽

Cancer Specific Survival ◽

Axillary Surgery ◽

Positive Lymph Nodes

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Association of germline genetic variants with breast cancer-specific survival in patient subgroups defined by clinic-pathological variables related to tumor biology and type of systemic treatment

Breast Cancer Research ◽

10.1186/s13058-021-01450-7 ◽

2021 ◽

Vol 23 (1) ◽

Author(s):

Anna Morra ◽

Maria Escala-Garcia ◽

Jonathan Beesley ◽

Renske Keeman ◽

Sander Canisius ◽

...

Keyword(s):

Breast Cancer ◽

Cancer Patients ◽

Genetic Variants ◽

Systemic Treatment ◽

European Ancestry ◽

Breast Cancer Specific Survival ◽

Breast Cancer Patients ◽

Cancer Specific Survival ◽

The Impact ◽

Patient Subgroups

Abstract Background Given the high heterogeneity among breast tumors, associations between common germline genetic variants and survival that may exist within specific subgroups could go undetected in an unstratified set of breast cancer patients. Methods We performed genome-wide association analyses within 15 subgroups of breast cancer patients based on prognostic factors, including hormone receptors, tumor grade, age, and type of systemic treatment. Analyses were based on 91,686 female patients of European ancestry from the Breast Cancer Association Consortium, including 7531 breast cancer-specific deaths over a median follow-up of 8.1 years. Cox regression was used to assess associations of common germline variants with 15-year and 5-year breast cancer-specific survival. We assessed the probability of these associations being true positives via the Bayesian false discovery probability (BFDP < 0.15). Results Evidence of associations with breast cancer-specific survival was observed in three patient subgroups, with variant rs5934618 in patients with grade 3 tumors (15-year-hazard ratio (HR) [95% confidence interval (CI)] 1.32 [1.20, 1.45], P = 1.4E−08, BFDP = 0.01, per G allele); variant rs4679741 in patients with ER-positive tumors treated with endocrine therapy (15-year-HR [95% CI] 1.18 [1.11, 1.26], P = 1.6E−07, BFDP = 0.09, per G allele); variants rs1106333 (15-year-HR [95% CI] 1.68 [1.39,2.03], P = 5.6E−08, BFDP = 0.12, per A allele) and rs78754389 (5-year-HR [95% CI] 1.79 [1.46,2.20], P = 1.7E−08, BFDP = 0.07, per A allele), in patients with ER-negative tumors treated with chemotherapy. Conclusions We found evidence of four loci associated with breast cancer-specific survival within three patient subgroups. There was limited evidence for the existence of associations in other patient subgroups. However, the power for many subgroups is limited due to the low number of events. Even so, our results suggest that the impact of common germline genetic variants on breast cancer-specific survival might be limited.

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COULD GENERAL SURGEONS WITH SPECIAL INTEREST IN BREAST SURGERY DELIVER A QUALITY SERVICE DESPITE A PARADIGM SHIFT TOWARDS SPECIALISATION? AN INDEPTH ANALYSIS OF QUALITY ASSESSMENT-BASED PRACTICE AT A GENERAL SURGEON-LED BREAST UNIT IN THE UNITED KINGDOM

10.36106/ijsr/1446383 ◽

2021 ◽

pp. 43-48

Author(s):

Pasupathy Kiruparan ◽

Mariana Matias ◽

Nanthesh Kiruparan ◽

David Archampong ◽

Debasish Debnath

Keyword(s):

Breast Cancer ◽

Overall Survival ◽

United Kingdom ◽

Local Recurrence ◽

Cancer Patients ◽

Breast Surgery ◽

Survival Rates ◽

Breast Cancer Patients ◽

The United Kingdom ◽

General Surgeons

Background: Despite specialisation, a small subset of general surgeons continues to provide breast services in the United Kingdom. We aimed to assess breast cancer i) local recurrence rate against the national benchmarks of <5% (for invasive cancer) and <10% (for noninvasive cancer) at 5- year, and ii) net survival rates against national record of 95.8% and 85.3%, at 1-year and 5-year, respectively. Methods: All breast cancers (between 01/05/2012 and 30/04/2013) at a district general hospital in the north-west of England were audited. Two general surgeons provided the breast service. One surgeon performed mostly excisional surgery and acted as a 'generalist'. The second surgeon also performed level 2 oncoplastic procedures and acted as an internal control as a 'specialist'. Results: Out of 270 cancers diagnosed, 203 patients underwent surgery. Six patients (out of 180 invasive cancers) developed local recurrences (3.33%). Two patients (out of 23 patients with Ductal Carcinoma-In-Situ) developed local recurrences (8.69%). There was no signicant intersurgeon variation in practice except a difference in the size of the excised lesions. 1-year and 5-year net survival rates amongst all female breast cancer patients were 97% and 87.3%, respectively. Overall survival at 5-year was 79.1%. Conclusions: The results demonstrate that in an unselected cohort of breast cancer patients, general surgeons with interest in breast surgery can achieve acceptable standards in terms of local recurrence at 5-year, and net survivals at 1-year and 5-year. No conceivable difference in practice between two surgeons with 'generalist' and 'specialist' skill-mix was noted. Low overall survival might reect wider health issues. This has implications in planning a local breast service and utilising constrained human resources in the era of specialisation.

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Prognosis of BRCA1/2-negative breast cancer patients with HBOC risk factors compared with sporadic breast cancer patients without HBOC risk factors

Japanese Journal of Clinical Oncology ◽

10.1093/jjco/hyz147 ◽

2020 ◽

Vol 50 (2) ◽

pp. 104-113

Author(s):

Jai Min Ryu ◽

Seok Jin Nam ◽

Seok Won Kim ◽

Jeong Eon Lee ◽

Byung Joo Chae ◽

...

Keyword(s):

Breast Cancer ◽

Risk Factors ◽

Ovarian Cancer ◽

Overall Survival ◽

Cancer Patients ◽

Disease Free Survival ◽

Breast Cancer Specific Survival ◽

Breast Cancer Patients ◽

Cancer Specific Survival ◽

Free Survival

Abstract Objective Demands for genetic counseling with BRCA1/2 examination have markedly increased. Accordingly, the incidence of uninformative results on BRCA1/2 mutation status has also increased. Because most patients examined for BRCA1/2 mutation have a high risk of hereditary breast and/or ovarian cancer, many patients suffer psychological distress even when the BRCA1/2 result is negative. We compared oncological outcomes between BRCA1/2-negative breast cancer with high risk of hereditary breast and/or ovarian cancer and sporadic breast cancer without risk of hereditary breast and/or ovarian cancer. Methods The criteria for high risk for hereditary breast and/or ovarian cancer were defined as family history of breast and/or ovarian cancer in first- or second-degree relative, early onset breast cancer at <35 years old and bilateral breast cancer. Patients were matched maximally 1:3 into those who identified as negative for BRCA1/2 mutation with risk of hereditary breast and/or ovarian cancer (study group) and those who were not examined for BRCA1/2 mutation without risk for hereditary breast and/or ovarian cancer (control group). Matched variables were pathologic stage, estrogen receptor, progesterone receptor and human epidermal growth factor receptor-2 status. Results All matching variables were successfully matched. Median follow-up duration was 57.8 months. There was no significant difference between the groups in disease-free survival (log-rank P = 0.197); however, the study group showed significantly better overall survival and breast cancer-specific survival (both P < 0.0001). We conducted subgroup analysis in the middle-aged group (36–54) and showed no significant difference for disease-free survival (P = 0.072) but significantly better overall survival and breast cancer-specific survival in the study group (P = 0.002 and P < 0.0001). Conclusions BRCA1/2-negative breast cancer patients who had hereditary breast and/or ovarian cancer risk factors showed similar disease-free survival and better overall survival and breast cancer-specific survival compared with those with sporadic breast cancer without hereditary breast and/or ovarian cancer risk factors.

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