scholarly journals The effect of postmastectomy radiotherapy in node-positive triple-negative breast cancer

BMC Cancer ◽  
2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Lei Zhang ◽  
Ru Tang ◽  
Jia-Peng Deng ◽  
Wen-Wen Zhang ◽  
Huan-Xin Lin ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Triple Negative ◽  
Cox Regression ◽  
Population Based ◽  
Breast Cancers ◽  
Cancer Specific Survival ◽  
Postmastectomy Radiotherapy ◽  
Pathological Staging ◽  
Node Positive ◽  
Advanced Tumor

Abstract Background The value of postmastectomy radiotherapy (PMRT) for pathological node-positive triple-negative breast cancers (TNBC) remains debatable. The aim of this population-based retrospective study was to evaluate the effect of PMRT on survival outcomes in this population. Methods Patients diagnosed with stage T1-4N1-N3M0 TNBC between 2010 and 2014 were identified from the Surveillance, Epidemiology, and End Results (SEER) database. We used univariate and multivariate Cox regression hazards method to determine the independent prognostic factors associated with 3-year breast cancer-specific survival (BCSS). The effect of PMRT on 3-year BCSS was analyzed after stratification by pathological staging of groups. Results Of the 4398 patients included in this study, 2649 (60.2%) received PMRT. Younger age, black ethnicity, and advanced tumor (T) and nodal (N) stage were the independent predictors associated with PMRT receipt (all P < 0.05). Patients who received PMRT showed better 3-year BCSS (OR = 0.720, 95% CI = 0.642–0.808, P < 0.001) than those that did not. The effect of PMRT on 3-year BCSS was analyzed after stratification by pathological staging of groups. The results showed that PMRT was associated with better 3-year BCSS in patients with stage T3–4N1 (P = 0.042), T1-4N2 (P < 0.001), and T1-4N3 (P < 0.001), while comparable 3-year BCSS was found between the PMRT and non-PMRT cohorts with T1–2N1 disease (P = 0.191). Conclusions Radiotherapy achieved better 3-year BCSS in TNBC patients with stage T3–4N1 and T1-4N2–3 disease. However, no survival benefit was found with the addition of PMRT in patients with T1–2N1 TNBC.

scholarly journals Effect of postmastectomy radiotherapy on T1-2N1M0 triple-negative breast cancer

2021 ◽  
Author(s):  
Lin-Yu Xia ◽  
Wei-Yun Xu ◽  
Zhao Yan
Keyword(s):  
Breast Cancer ◽  
Triple Negative ◽  
Population Based ◽  
Positive Lymph Node ◽  
Breast Cancers ◽  
Cancer Specific Survival ◽  
Population Based Study ◽  
Postmastectomy Radiotherapy ◽  
Cox Proportional Hazard ◽  
Kaplan Meier

Abstract Background: The effect of postmastectomy radiotherapy (PMRT) on T1-2N1M0 triple-negative breast cancers (TNBC) remains unclear. The population-based study aimed to investigate the survival outcomes of T1-2N1M0 TNBC patients who underwent PMRT or not. Methods: We selected 1743 patients with T1-2N1M0 TNBC who underwent mastectomy between 2010 and 2015 through the Surveillance, Epidemiology and End Results (SEER) database. After propensity score matching (PSM) , the PMRT and no-PMRT groups consisted of 586 matched patients, respectively.The Kaplan-Meier method was applied to calculate breast cancer-specific survival (BCSS) and cox proportional hazard model were used to determine the prognostic factors of T1-2N1M0 TNBC.Results: The 5-year BCSS for the PMRT group and no-PMRT group was 79.1% and 74.7%, respectively. TNBC patients with stage T1-2N1M0 receiving PMRT did not show better BCSS than those did not (HR =0.800, 95% CI =0.605-1.056, P =0.115). Subgroup analysis showed that in patients with three nodes positive, radiotherapy could significantly improve BCSS(HR=0.396, 95% CI = 0.175-0.900, P = 0.027), but it brought no significant advantage in BCSS in patients with one or two nodes positive(HR =1.061, 95% CI =0.725-1.552, P =0.761; HR =0.657, 95% CI =0.405-1.065, P =0.088).In addition, PMRT improves the BCSS in TNBC patients with T2 tumor concomitant with three positive lymph nodes(HR =0.343, 95% CI =0.132-0.890, P =0.028).Conclusion: TNBC patients with T2 tumor concomitant with three positive lymph node can benefit from PMRT.

scholarly journals Comparison of survival in non-metastatic inflammatory and other T4 breast cancers: a SEER population-based analysis

BMC Cancer ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Dechuang Jiao ◽  
Jingyang Zhang ◽  
Jiujun Zhu ◽  
Xuhui Guo ◽  
Yue Yang ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cox Model ◽  
Survival Rates ◽  
Tumor Grade ◽  
Population Based ◽  
Rank Test ◽  
Breast Cancers ◽  
Significant Independent Predictor ◽  
Cancer Specific Survival ◽  
7Th Edition

Abstract Background Previous studies have reported poor survival rates in inflammatory breast cancer (IBC) patients than non-inflammatory local advanced breast cancer (non-IBC) patients. However, until now, the survival rate of IBC and other T4 non-IBC (T4-non-IBC) patients remains unexplored. Methods Surveillance, Epidemiology, and End Results (SEER) database was searched to identify cases with confirmed non-metastatic IBC and T4-non-IBC who had received surgery, chemotherapy, and radiotherapy between 2010 and 2015. IBC was defined as per the American Joint Committee on Cancer (AJCC) 7th edition. Breast Cancer-Specific Survival (BCSS) was estimated by plotting the Kaplan-Meier curve and compared across groups by using the log-rank test. Cox model was constructed to determine the association between IBC and BCSS after adjusting for age, race, stage of disease, tumor grade and surgery type. Results Out of a total of 1986 patients, 37.1% had IBC and mean age was 56.6 ± 12.4. After a median follow-up time of 28 months, 3-year BCSS rate for IBC and T4-non-IBC patients was 81.4 and 81.9%, respectively (log-rank p = 0.398). The 3-year BCSS rate in HR−/HER2+ cohort was higher for IBC patients than T4-non-IBC patients (89.5% vs. 80.8%; log-rank p = 0.028), and in HR−/HER2- cohort it was significantly lower for IBC patients than T4-non-IBC patients (57.4% vs. 67.5%; log-rank p = 0.010). However, it was identical between IBC and T4-non-IBC patients in both HR+/HER2- (85.0% vs. 85.3%; log-rank p = 0.567) and HR+/HER2+ (93.6% vs. 91.0%, log-rank p = 0.510) cohorts. After adjusting for potential confounding variables, we observed that IBC is a significant independent predictor for survival of HR−/HER2+ cohort (hazards ratio [HR] = 0.442; 95% CI: 0.216–0.902; P = 0.025) and HR−/HER2- cohort (HR = 1.738; 95% CI: 1.192–2.534; P = 0.004). Conclusions Patients with IBC and T4-non-IBC had a similar BCSS in the era of modern systemic treatment. In IBC patients, the HR−/HER2+ subtype is associated with a better outcome, and HR−/HER2- subtype is associated with poorer outcomes as compared to the T4-non-IBC patients.

Influence of radiation therapy on the outcome of T1-2N0M0 triple-negative breast cancer: A SEER population-based retrospective analysis.

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. e12073-e12073
Author(s):  
Xiaoxiang Guan ◽  
Huan Li ◽  
Yajuan Chen ◽  
Xin Wang ◽  
Lin Tang ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Radiation Therapy ◽  
Retrospective Analysis ◽  
Triple Negative Breast Cancer ◽  
Survival Benefit ◽  
Triple Negative ◽  
Breast Conservation ◽  
Population Based ◽  
Axillary Staging ◽  
Cancer Specific Survival

e12073 Background: For T1-2N0M0 breast cancer after surgery and axillary staging, the current NCCN guideline recommends radiation therapy (RT) after lumpectomy but not total mastectomy unless there is a positive or less than 1 mm negative margin. This recommendation is regardless of hormonal status. Triple-negative breast cancer is a generally considered more aggressive compared with hormone positive breast cancer. We sought to investigate whether there is a survival benefit of RT in T1-2N0M0 TNBC. Methods: A Population-based retrospective analysis was performed using the Surveillance, Epidemiology, and End Results (SEER) database. Patients included in the analysis were divided into three groups according to surgery modality and RT: breast conservation therapy (BCT, i.e., lumpectomy + RT), mastectomy alone, and mastectomy + RT. The survival endpoints were breast cancer-specific survival (BCSS) and overall survival (OS), and survival analysis was performed using the Kaplan-Meier method. Results: A total of 22473 female with T1-2N0M0 TNBC diagnosed between 2010 and 2015 were included, with 13395 (60%) T1 and 9078 (40%) T2 cases. Surgery, RT and chemotherapy was done in 21674 (96%), 9633 (43%) and 14651 (65%) patients, respectively. Patients who underwent RT were older ( > 50 years, 78% vs 72%, P< 0.001), had fewer T2 (35% vs 44%, P< 0.001) tumor, and had more chemotherapy utilization (72% vs 60%, P< 0.001). 8807 patients had BCT; 8329 had mastectomy alone and 635 had mastectomy + RT. The 5-year BCSS rate was 94.3% for BCT, 93.3% for mastectomy alone ( P= 0.009 vs BCT), and 83.7% for mastectomy + RT ( P< 0.001 vs BCT and P< 0.001 vs mastectomy alone), respectively. The 5-year OS rate was 88.6% for BCT, 83.0 % for mastectomy alone ( P< 0.001 vs BCT), and 79.6% for mastectomy + RT ( P< 0.001 vs BCT and P= 0.190 vs mastectomy alone), respectively. Conclusions: In patients with T1-2N0M0 TNBC, BCT was associated with superior BCSS and OS compared to mastectomy with or without RT. After mastectomy, there was no evidence of survival benefit of RT, with worse BCSS and similar OS.

Rare triple-negative breast cancers (TNBC): An NCDB analysis.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. e19253-e19253
Author(s):  
Elizabeth Blessing Elimimian ◽  
Thomas A. Samuel ◽  
Hong Liang ◽  
Nadeem Bilani ◽  
Leah Elson ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Overall Survival ◽  
Radiation Therapy ◽  
Lung Metastasis ◽  
Triple Negative ◽  
Cox Regression ◽  
Prognostic Indicators ◽  
Future Research ◽  
Breast Cancers ◽  
P Values

e19253 Background: The literature on rare triple negative breast cancer (TNBC) histology types is sparse; herein we present the clinical demographic and treatment patterns as well as overall survival (OS) for rare (< 10%) types of breast cancers that typically present as TNBCs: Medullary carcinoma (MedC), Adenoid cystic carcinoma (ACC), and Metaplastic breast cancer (MetC). Methods: Records of patients with a confirmed diagnosis of MedC, ACC, and MetC between 2010 and 2016 in the National Cancer Database (NCDB) were analyzed. Patients with an unknown stage were excluded. Univariate analyses and multivariable Cox-regression models were performed in SAS v. 9.4. Results: A total of 8,479 records were analyzed. MetC was the most commonly diagnosed histologic type in our cohort with 6,867 (81%) patients versus 255 (3.0%) MedC patients and 1,357 (16%) ACC patients. MedC presented earlier in life, with a median age of 53 years versus 62 years for ACC patients, and 63 years for MetC patients. The proportion of TNBC varied by histology type for MedC (70.4%), ACC (77.0%), and MetC (79.0 %). Patients with ACC were less likely to receive radiotherapy (52.4%) and chemotherapy (12.9%) compared to MedC (61.2%, 74.5%) and MetC (49.7%, 68.6%) respectively. On Cox multivariate regression, age ≥60 (HR 4.7), stage ≥3 [compared to patients with stage 0&1] (HR 5.7), and not receiving radiotherapy (HR 2.0) or chemotherapy (HR 1.25) conferred worse overall survival for MedC. Similarly, among patients with ACC, age ≥60 (HR 3.5), stage ≥3 (HR 5.3), and lymph node involvement (HR 4.8) were adverse prognostic indicators as well as not receiving radiation therapy (HR 1.47). Among MetC, lung metastasis (HR 2.6), stage ≥3 (HR 4.5), but also not receiving chemotherapy (HR 1.8) or radiation therapy (HR 1.47) was associated with worse survival outcomes. All p-values for cox regression is <0.0001. The 5-year OS was 92.6% for patients with MedC, 92.0% for ACC patients, 69.3% for MetC patients; all p-values <0.0001. Conclusions: This analysis describes rare types of TNBCs: MedC (most common), ACC, and MetC. We noted heterogeneity among these 3 rare types of TNBC, with the worst 5-year OS noted for MetC. Poor prognostic factors for MetC include advanced stage, lung metastasis, older age, and not receiving chemotherapy or radiation therapy. Future research focusing on rare subtypes of breast cancer is desirable and would potentially inform the optimal management of these breast carcinomas.

scholarly journals Sex-Based Heterogeneity in the Clinicopathological Characteristics and Prognosis of Breast Cancer: A Population-Based Analysis

2021 ◽  
Vol 11 ◽  
Author(s):  
Yiqun Han ◽  
Jiayu Wang ◽  
Zijing Wang ◽  
Binghe Xu
Keyword(s):  
Breast Cancer ◽  
Cox Regression ◽  
Ductal Carcinoma ◽  
Molecular Subtype ◽  
Histological Grade ◽  
Population Based ◽  
Clinicopathological Characteristics ◽  
Clinicopathological Features ◽  
Disease Stage ◽  
Cancer Specific Survival

PurposeTo better understand the differences in clinicopathological features and prognosis between male breast cancer (MBC) and female breast cancer (FBC).Material and MethodsData on patients diagnosed with breast cancer from January 1, 2010, to December 31, 2016, were obtained from the Surveillance, Epidemiology, and End Results database. Selected patients were classified into MBC and FBC, of which population demographics and clinicopathological features at baseline were successively extracted for analysis. Comparative analysis was performed to explore the differences in baseline characteristics, followed by propensity-score matching to calibrate the objective distinctions for adjusted analysis. Survival analysis was carried out to investigate divergences presented in prognosis from the two cohorts, and risk factors for prognosis were successively identified using univariate and multivariate COX regression analyses.ResultsA total of 407341 individuals were eligible, including 3111 MBC (0.7%) and 404230 FBC (99.3%) patients. Comparatively, patients with MBC tended to be older at diagnosis, with a higher confirmation of ductal carcinoma, a higher histological grade, a higher TNM stage, a higher proportion of luminal-like subtype, a higher rate of lung metastasis, a lower incidence of liver involvement, and a lower rate of surgical, radiation, and chemotherapeutic delivery. The overall prognosis of MBC was significantly worse than that of FBC, with a decreasing divergence both in median overall survival (65.5 months vs. 72.7 months, P&lt;0.0001) and median breast cancer-specific survival (75.4 months vs. 77.8 months, P&lt;0.0001). However, these discrepancies were not consistent among patients from different subgroups stratified by molecular subtype, age at diagnosis, or disease stage.ConclusionIn this study, sex-based heterogeneity in clinicopathological characteristics and prognostic profiles was observed in the overall population of patients with breast cancer and was significantly variable among different subgroups. A male-specific design with reasonable endpoints for a clinical trial protocol will be warranted in the future.

Increased Risk for Depression After Breast Cancer: A Nationwide Population-Based Cohort Study of Associated Factors in Denmark, 1998-2011

2014 ◽  
Vol 32 (34) ◽  
pp. 3831-3839 ◽  
Author(s):  
Nis P. Suppli ◽  
Christoffer Johansen ◽  
Jane Christensen ◽  
Lars V. Kessing ◽  
Niels Kroman ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cox Regression ◽  
Population Based ◽  
First Year ◽  
Node Positive ◽  
Increased Risk ◽  
Node Positive Disease ◽  
Rate Ratios ◽  
Hospital Contact ◽  
Risk For Depression

Purpose To investigate the risk for first depression, assessed as incident hospital contacts for depression and incident use of antidepressants, among women with breast cancer. Patients and Methods Danish national registries were used to identify 1,997,669 women with no diagnosis of cancer or a major psychiatric disorder. This cohort was followed from 1998 to 2011 for a diagnosis of breast cancer and for the two outcomes, hospital contact for depression and redeemed prescriptions for antidepressants. Rate ratios for incident hospital contacts for depression and incident use of antidepressants were estimated with Poisson regression models. Multivariable Cox regression was used to evaluate factors associated with the two outcomes among patients with breast cancer. Results We identified 44,494 women with breast cancer. In the first year after diagnosis, the rate ratio for a hospital contact for depression was 1.70 (95% CI 1.41 to 2.05) and that for use of antidepressants was 3.09 (95% CI 2.95 to 3.22); these rate ratios were significantly increased after 3 and 8 years, respectively. Comorbidity, node-positive disease, older age, basic and vocational educational levels, and living alone were associated with use of antidepressants. Conclusion Women with breast cancer are at long-term increased risk for first depression, including both severe episodes leading to hospital contact and use of antidepressants. Clinicians should be aware that the risk is highest in women with comorbid conditions, node-positive disease, and age of 70 years or more. We found no clear association between type of surgery or adjuvant treatment and risk for depression.

scholarly journals Androgen receptor and FOXA1 coexpression define a “luminal-AR” subtype of feline mammary carcinomas, spontaneous models of breast cancer

BMC Cancer ◽  
2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Elie Dagher ◽  
Violette Royer ◽  
Paul Buchet ◽  
Jérôme Abadie ◽  
Delphine Loussouarn ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Androgen Receptor ◽  
Triple Negative Breast Cancer ◽  
Triple Negative ◽  
Breast Cancers ◽  
Cancer Specific Survival ◽  
Ki 67 ◽  
Mammary Carcinomas ◽  
Definition Of

Abstract Background Invasive mammary carcinomas that spontaneously develop in female cats are associated with high mortality, and resemble the most aggressive human breast cancers, especially triple-negative breast cancer (TNBC). Transcriptome studies showed that TNBCs are a heterogeneous group that includes a potentially hormone-dependent subtype named luminal-AR. Some authors proposed an immunohistochemical definition of the luminal-AR subtype, which is not only positive for Androgen Receptor (AR), but also either positive for the transcription factor Forkhead box A1 (FOXA1), or negative for basal markers. The objectives of this study were to describe AR and FOXA1 expressions in feline mammary carcinomas (FMCs), their prognostic value, and if their coexpression could define a “luminal-AR” subtype of triple-negative mammary carcinomas in cats. Methods In a previously described retrospective cohort of 180 female cats with FMCs, with a 2-year follow-up post-mastectomy, we assessed AR, FOXA1, ER, PR, Ki-67, HER2, and CK14 expressions by automated immunohistochemistry. Results Of the 180 FMCs, 57 (32%) were luminal; i.e., ER and/or PR positive, and 123 (68%) were triple-negative (ER–, PR– and HER2–) FMCs. AR overexpression (found in 33 cases/180, 18%) and FOXA1 index ≥1% (64/180, 36%) were associated with a longer disease-free interval, overall survival, and cancer-specific survival in cats with FMC. Analysis of AR, FOXA1 and CK14 coexpression in triple-negative FMCs showed that AR+ triple-negative FMCs were heterogeneous: there existed an AR+ FOXA1+ CK14– subgroup (n = 7) associated with a better cancer-specific survival by multivariate survival analysis (HR = 0.26, 95% CI: 0.07–0.89, p = 0.03) compared to AR+ FOXA1–CK14+ triple-negative FMCs (n = 46) (HR = 1.00), independently of the pathologic tumor size and pathologic nodal stage. The non-basal-like subtype of triple-negative FMCs that coexpresses AR and FOXA1 (the AR+ FOXA1+ CK14– subgroup) could represent the equivalent of the luminal-AR subgroup of human triple-negative breast cancer. Conclusions We identified an AR+ FOXA1+ CK14– subgroup of triple-negative FMCs that might correspond to the luminal-AR subgroup of human triple-negative breast cancers. Cats with FMC may be interesting spontaneous animal models to investigate new strategies targeting the androgen receptor, especially in the aggressive subtype of AR+ basal-like triple-negative mammary carcinomas with loss of FOXA1 expression (the AR+ FOXA1–CK14+ subgroup).

Nestin is expressed in basal-like and triple negative breast cancers

2008 ◽  
Vol 61 (9) ◽  
pp. 1045-1050 ◽  
Author(s):  
S Parry ◽  
K Savage ◽  
C Marchiò ◽  
J S Reis-Filho
Keyword(s):  
Breast Cancer ◽  
Triple Negative ◽  
Prognostic Impact ◽  
Breast Cancers ◽  
Breast Cancer Patients ◽  
Breast Carcinomas ◽  
Nestin Expression ◽  
Cancer Specific Survival ◽  
Quantitative Scoring ◽  
Grade Iii

Aims:To analyse the distribution of nestin expression in different breast tumours and to determine the prognostic impact of nestin expression.Methods:Nestin expression was immunohistochemically analysed in a cohort of 245 invasive breast cancer patients treated with therapeutic surgery followed by anthracycline-based chemotherapy using a semi-quantitative scoring system.Results:Nestin was exclusively expressed in grade III breast carcinoma and preferentially expressed in basal-like and triple negative cancers. Nestin-positive tumours displayed high proliferation rates and p53 nuclear expression. Lymph-node positive patients with nestin-positive cancers had a shorter breast cancer specific survival; however nestin was not an independent prognostic factor on multivariate analysis.Conclusions:Nestin expression is preferentially found in basal-like and triple negative breast carcinomas. Further studies are warranted to define the biological role played by nestin in these subgroups of breast cancers.

scholarly journals METTL14 and miR-1247 are associated with poor outcomes in Triple-Negative Breast Cancer

2020 ◽  
Author(s):  
Junbo Hu ◽  
Mingyue Hou ◽  
Bo Chen ◽  
Huan Wu ◽  
You Cai ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Triple Negative Breast Cancer ◽  
Triple Negative ◽  
Cox Regression ◽  
Diagnostic Tools ◽  
Breast Cancers ◽  
Breast Cancer Patients ◽  
Cox Regression Analysis ◽  
Expression Levels ◽  
Poor Outcomes

Abstract BackgroundTriple-negative breast cancer (TNBC) doesn’t have targets for therapy, and accounts for 15% of all breast cancers. m6A modification has been reported to play important role in the progression of various cancers. However, the expression and function of the m6A methyltransferase METTL14 in TNBC are unclear. MethodsThe count data of miRNA and mRNA of breast cancer patients with both tumor tissues and matched nomal tissues were downloaded from the TCGA data portal. The expression of METTL14 was determined by immunohistochemistry and western blot. The expression of has-miR-1247 was determined by qRT-PCR.The Cox regression analysis was executed for the expression levels of METTL14 and DEmiRNAs .The Kaplan-Meier survival analysis were performed to establish the correlation between the expression level and survival of BC patients .ResultsWe discovered that METTL14 was significantly downregulated in TNBC tissues, and low expression of METTL14 is correlated with worse differentiation ,higher ki67 proliferation and poorer survival suggesting its potential as an independent prognostic biomarker for TNBC. We also found the positive correlation between the expression levels of METTL14 and has-miR-1247. Moreover, has-miR-1247 was significantly downregulated in TNBC tissues, and lead to poorer survival.ConclusionOur data suggested that METTL14 and miR-1247 could be valuable diagnostic tools, prognostic biomarkers, and therapeutic targets for TNBC.

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