scholarly journals Risk and prognostic factors of breast cancer with liver metastases

BMC Cancer ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Lei Ji ◽  
Lei Cheng ◽  
Xiuzhi Zhu ◽  
Yu Gao ◽  
Lei Fan ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Risk Factors ◽  
Prognostic Factors ◽  
Targeted Therapy ◽  
Liver Metastasis ◽  
Cancer Patients ◽  
Triple Negative ◽  
Seer Database ◽  
Breast Cancer Patients ◽  
Death Risk

Abstract Background Liver metastasis is a significant adverse predictor of overall survival (OS) among breast cancer patients. The purpose of this study was to determine the risk and prognostic factors of breast cancer with liver metastases (BCLM). Methods Data on 311,573 breast cancer patients from the Surveillance, Epidemiology, and End Results (SEER) database and 1728 BCLM patients from Fudan University Shanghai Cancer Center (FUSCC) were included. Logistic regression was used to identify risk factors for liver metastasis. Cox proportional hazards regression model was adopted to determine independent prognostic factors in BCLM patients. Results Young age, invasive ductal carcinoma, higher pathological grade, and subtype of triple-negative and human epidermal growth factor receptor 2 positive (HER2+) were risk factors for developing liver metastasis. The median OS after liver metastasis was 20.0 months in the SEER database and 27.3 months in the FUSCC dataset. Molecular subtypes also played a critical role in the survival of BCLM patients. We observed that hormone receptor-positive (HR+)/HER2+ patients had the longest median OS (38.0 for SEER vs. 34.0 months for FUSCC), whereas triple-negative breast cancer had the shortest OS (9.0 vs. 15.6 months) in both SEER and FUSCC. According to the results from the FUSCC, the subtype of HR+/HER2+ (hazard ratio (HR) = 2.62; 95% confidence interval (CI) = 1.88–3.66; P < 0.001) and HR−/HER2+ (HR = 3.43; 95% CI = 2.28–5.15; P < 0.001) were associated with a significantly increased death risk in comparison with HR+/HER2- patients if these patients did not receive HER2-targeted therapy. For those who underwent HER2-targeted therapy, however, HR+/HER2+ subtype reduced death risk compared with HR+/HER2- subtype (HR = 0.74; 95% CI = 0.58–0.95; P < 0.001). Conclusions Breast cancer patients at a high risk for developing liver metastasis deserve more attention during the follow-up. BCLM patients with HR+/HER2+ subtype displayed the longest median survival than HR+/HER2- and triple-negative patients due to the introduction of HER2-targeted therapy and therefore it should be recommended for HER2+ BCLM patients.

scholarly journals Risk and prognostic factors of breast cancer with liver metastases

2020 ◽  
Author(s):  
Lei ji ◽  
Lei Cheng ◽  
Xiuzhi Zhu ◽  
Yu Gao ◽  
Lei Fan ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Risk Factors ◽  
Prognostic Factors ◽  
Targeted Therapy ◽  
Liver Metastasis ◽  
Cancer Patients ◽  
Triple Negative ◽  
Seer Database ◽  
Breast Cancer Patients ◽  
Death Risk

Abstract Background: Liver metastasis is a significant adverse predictor of overall survival (OS) among breast cancer patients. The purpose of this study was to determine the risk and prognostic factors of breast cancer with liver metastases (BCLM). Methods: Data on 311,573 breast cancer patients from the Surveillance, Epidemiology, and End Results (SEER) database and 1728 BCLM patients from Fudan University Shanghai Cancer Center (FUSCC) were included. Logistic regression was used to identify risk factors for liver metastasis. Cox proportional hazards regression model was adopted to determine independent prognostic factors in BCLM patients.Results: Young age, invasive ductal carcinoma, higher pathological grade, and subtype of triple-negative and human epidermal growth factor receptor 2 positive (HER2+) were risk factors for developing liver metastasis. The median OS after liver metastasis was 20.0 months in the SEER database and 27.3 months in the FUSCC dataset. Molecular subtypes also played a critical role in the survival of BCLM patients. We observed that hormone receptor-positive (HR+)/HER2+ patients had the longest median OS (38.0 for SEER vs. 34.0months for FUSCC), whereas triple-negative breast cancer had the shortest OS (9.0 vs. 15.6 months) in both SEER and FUSCC. According to the results from the FUSCC, the subtype of HR+/HER2+ (hazard ratio (HR)=2.62; 95% confidence interval (CI)= 1.88-3.66; P<0.001) and HR-/HER2+ (HR=3.43; 95% CI=2.28-5.15; P<0.001) were associated with a significantly increased death risk in comparison with HR+/HER2- patients if these patients did not receive HER2-targeted therapy. For those who underwent HER2-targeted therapy, however, HR+/HER2+ subtype reduced death risk compared with HR+/HER2- subtype (HR=0.74; 95% CI=0.58-0.95; P<0.001).Conclusions: Breast cancer patients at a high risk for developing liver metastasis deserve more attention during the follow-up. BCLM patients with HR+/HER2+ subtype displayed the longest median survival than HR+/HER2- and triple-negative patients due to the introduction of HER2-targeted therapy and therefore it should be recommended for HER2+ BCLM patients.

scholarly journals Clinicopathologic and outcome characteristics of breast cancer with liver metastases (BCLM): a population study of the SEER database and a registry analysis of 1728 women

2020 ◽  
Author(s):  
zhonghua wang ◽  
Lei ji ◽  
Lei Cheng ◽  
Xiuzhi Zhu ◽  
Yu Gao ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Targeted Therapy ◽  
Liver Metastases ◽  
Cancer Patients ◽  
Triple Negative ◽  
Cancer Center ◽  
Seer Database ◽  
Breast Cancer Patients ◽  
Death Risk ◽  
Increased Risk

Abstract Background Breast cancer patients generally have a worse prognosis in presence of liver metastasis. The purpose of this study was to evaluate the risk factors and prognosis of breast cancer patients with liver metastases (BCLM). Methods Data on 311,573 breast cancer patients from the Surveillance, Epidemiology, and End Results (SEER) database diagnosed 2010 to 2016 and 1728 BCLM patients from Fudan University Shanghai Cancer Center (FUSCC) were analyzed for further exploration. We extracted the clinicopathological characteristics for analysis by two independent authors. Logistic regression was used to identify factors associated with the risk of liver metastases. Survival analysis was completed using Cox proportional hazards regression model and Kaplan-Meier analysis. Results Young age, invasive ductal carcinoma, higher pathological grade, and subtype of triple-negative and human epidermal growth factor receptor 2 positive (HER2+), were associated with increased risk of the liver metastases. The median overall survival (OS) after BCLM diagnosis was 20.0 months in the SEER database and 27.3 months in the FUSCC dataset. We observed that hormone receptor-positive (HR+)/HER2+ patients had the longest median OS 38.0 for SEER vs. 34.0months for FUSCC), whereas triple-negative breast cancer had the poorest OS (9.0 vs. 15.6 months) in both SEER and FUSCC. According to the results from the FUSCC, the subtype of HR+/HER2+ (hazard ratio (HR)=2.62; 95% confidence interval (CI)= 1.88-3.66; P<0.001) and HR-/HER2+ (HR=3.43; 95% CI=2.28-5.15; P<0.001) were associated with a significantly increased death risk in comparison with subtype of HR+/HER2-, if the patients did not receive HER2-targeted therapy. For BCLM patients who had received HER2-targeted therapy, however, HR+/HER2+ was an indicator for decreased death risk in comparison of the subtype of HR+/HER2- (HR=0.74; 95% CI=0.58-0.95; P<0.001). Conclusions BCLM is associated with poor survival, depending on HR/HER2-defined subtypes. Patients with HR+/HER2+ subtype displayed the longest median survival than HR+/HER2- and triple-negative BCLM patients. HER2-targeted therapy should be recommended for HER2+ BCLM patients.

Prognostic factors in breast cancer patients evaluated by PET/CT prior to neoadjuvant chemotherapy.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. e12113-e12113
Author(s):  
Mark K Farrugia ◽  
Geraldine M. Jacobson ◽  
Mohamad Adham Salkeni
Keyword(s):  
Breast Cancer ◽  
Prognostic Factors ◽  
Neoadjuvant Chemotherapy ◽  
Cancer Patients ◽  
Triple Negative ◽  
Primary Breast Tumor ◽  
Breast Cancer Patients ◽  
Her2 Positive ◽  
Pet Ct ◽  
Pre Treatment

e12113 Background: Neoadjuvant chemotherapy (NAC) is an important modality in breast cancer treatment. We sought to identify pre-treatment prognostic factors in patients who had positron emission tomography paired with diagnostic quality contrast-enhanced CT (PET/CT) prior to neoadjuvant chemotherapy with respect to pathologic complete response (pCR) , survival and relapse-free survival (RFS). Methods: We retrospectively analyzed 118 breast cancer patients who had pre-treatment PET/CT imaging and received NAC from 2008-2014. We collected data on molecular markers, PET/CT, pCR, survival, and disease status. Results: The median follow up was 44 months(range 7.3-101.5),median age was 51 years; 47% were stage II, 53% stage III. 52% of patients had hormone receptor (HR) positive/HER2 negative disease, 31% of tumors were HER2 positive, and 17% of tumors were triple-negative. 92.5% with HER2 positive tumors received NAC containing at least one HER2 targeted agent. Pre-treatment standard uptake value (SUV) max of the primary breast tumor showed no statistically significant relationship to survival, RFS, or pCR. PET avid (>2 SUV) extra-axillary nodes such as internal mammary and supraclavicular was associated with a non-statistically significant trend towards reduced RFS (p=0.06, HR=0.13-1.06). pCR overall was 37.5% for HER2 positive tumors, 15% in triple-negative tumors, and 8% in HR positive/HER2 negative tumors. Log-rank analysis with post-hoc pairwise comparisons showed a significant difference between the RFS of triple-negative tumors and HER2 positive tumors (p=0.001), while comparison between HR positive/HER2 negative and HER2 positive was not statistically significant (p=0.11). Multivariate cox regression analysis, which included grade and stage of tumors, showed HER2 positivity to be associated with a favorable outcome (p=0.04, HR=0.22 (0.05-0.94)). Conclusions: Within this cohort, pre-treatment SUV max of the primary tumor showed no prognostic value with regard pCR or RFS. PET avid extra-axillary metastasis trended towards reduced RFS. Patients with HER2 positive tumors had the highest pCR and RFS comparable to classically favorable subgroups such as HR positive/HER 2 negative.

Targeted therapy and drug resistance in triple-negative breast cancer: the EGFR axis

2020 ◽  
Vol 48 (2) ◽  
pp. 657-665 ◽  
Author(s):  
Sima Lev
Keyword(s):  
Breast Cancer ◽  
Targeted Therapy ◽  
Cancer Patients ◽  
Triple Negative Breast Cancer ◽  
Targeted Therapies ◽  
Triple Negative ◽  
Therapeutic Targets ◽  
Resistance Mechanisms ◽  
Breast Cancer Patients ◽  
Positive Breast Cancer

Targeting of estrogen receptor is commonly used as a first-line treatment for hormone-positive breast cancer patients, and is considered as a keystone of systemic cancer therapy. Likewise, HER2-targeted therapy significantly improved the survival of HER2-positive breast cancer patients, indicating that targeted therapy is a powerful therapeutic strategy for breast cancer. However, for triple-negative breast cancer (TNBC), an aggressive breast cancer subtype, there are no clinically approved targeted therapies, and thus, an urgent need to identify potent, highly effective therapeutic targets. In this mini-review, we describe general strategies to inhibit tumor growth by targeted therapies and briefly discuss emerging resistance mechanisms. Particularly, we focus on therapeutic targets for TNBC and discuss combination therapies targeting the epidermal growth factor receptor (EGFR) and associated resistance mechanisms.

scholarly journals NTRK, RET, ROS1, and ALK Gene Fusion in HER2 Immunohistochemistry 2+ Breast Carcinoma

2021 ◽  
Author(s):  
Shafei Wu ◽  
Xiaohua Shi ◽  
Kaimi Li ◽  
Ying Jiang ◽  
Yuanyuan Liu ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Clinical Practice ◽  
Targeted Therapy ◽  
Breast Carcinoma ◽  
Cancer Patients ◽  
Triple Negative ◽  
Fusion Rate ◽  
Fusion Genes ◽  
Breast Cancer Patients ◽  
Cell Lung Carcinoma

Abstract ObjectiveHER2 immunohistochemistry (IHC) 2+ breast cancer patients need to determine the final HER2 status by fluorescence in situ hybridization (FISH) for selection of suitable treatment options. Although the HER2-positive cases can benefit from the anti-HER2 targeted therapy, it only made a small proportion of this group, so finding more targeted therapy methods is necessary. NTRK, RET, ROS1 and RET gene fusions have been fully investigated in non-small cell lung carcinoma and are subject to targeted therapy in clinical practice and trials. However, there are only few reports investigating these four fusion genes in breast cancer. Our study is designed to evaluate the four fusion genes in HER2 IHC 2+ breast cancer patients to find an alternative treatment option. MethodsOne hundred and seventy-seven tissue samples were included. IHC was employed to assess ALK and NTRK protein levels. FISH probes specific for HER2, ALK, NTRK1, NTRK2, NTRK3, ROS1 and RET were used. ResultsThe HER2-positivity rate of all HER2 IHC 2+ cases were 5.7%. The total fusion rate of the four oncogenes was 3.95% in HER2 IHC 2+ breast cancer patients. The fusion-positive patients were prone to be ER/PR/HER2 IHC triple negative (P=0.01) and were associated with poorly differentiated tumor (P=0.005). The NTRK, RET, ROS1, and ALK fusion rate was 0.56%, 1.13%, 1.13%, 1.13%, respectively. ConclusionsNRTK, RET, ROS1, and ALK fusion rearrangements were detected in triple-negative breast carcinoma patients which can provide patients with alternate treatment opportunities in clinical practice.

scholarly journals Prognostic factors and survival outcomes according to tumor subtype in patients with breast cancer lung metastases

PeerJ ◽  
2019 ◽  
Vol 7 ◽  
pp. e8298
Author(s):  
Siying Chen ◽  
Jin Yang ◽  
Yang Liu ◽  
Haisheng You ◽  
Yalin Dong ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Prognostic Factors ◽  
Metastatic Breast Cancer ◽  
Cancer Patients ◽  
Triple Negative ◽  
Cox Regression ◽  
Lung Metastases ◽  
Metastatic Breast ◽  
Breast Cancer Patients ◽  
Metastatic Sites

Background Reports on the incidence and prognoses of lung metastases when diagnosing breast cancer patients with different subtypes are limited. Our study investigated the effect of molecular sub-typing stratification on the prognoses of lung metastatic breast caner patients. Methods Patients with breast cancer and lung metastases were identified from Surveillance, Epidemiology and End Results population-based data between 2010 and 2015. Univariate and multivariate Cox regression analyses were performed to identify risk factors and prognoses, overall survival (OS) and breast cancer-specific survival for patients with breast cancer lung metastases. Results We identified 6,516 patients with lung metastatic breast cancer, representing 1.7% of the entire cohort and 30.4% of the subset with metastatic disease. This included 2,940 hormone receptor (HR)+/HER2− patients, 852 HR+/HER2+ patients, 547 HR−/HER2+ patients and 983 triple-negative patients. The median OS for all lung metastatic patients was 13 months. Multivariate analysis revealed that those lung metastatic breast cancer patients of older age (>80), black race, with poorly differentiated tumors, carcinoma histology, triple-negative subtype, more metastatic sites and no surgery, and no chemotherapy showed significantly poor survival, both overall and breast cancer-specific. Conclusions Our findings show that molecular sub-type and more metastatic sites might have significant influence on the incidence and prognosis of breast cancer lung metastases. We also identified several prognostic factors that could guide therapy selection in the treatment of lung metastatic patients.

Association of CA 15-3 and CEA with Liver Metastases in Patients with Breast Cancer

2020 ◽  
Vol 16 (4) ◽  
pp. 332-336
Author(s):  
Akram Yazdani ◽  
Hossein Akbari
Keyword(s):  
Breast Cancer ◽  
Prognostic Factors ◽  
Liver Metastasis ◽  
Liver Metastases ◽  
Cancer Patients ◽  
Tumor Size ◽  
Menopausal Status ◽  
Axillary Lymph Nodes ◽  
Axillary Lymph ◽  
Breast Cancer Patients

Objective: The liver is the second most common site of distant metastasis from breast cancer that is usually associated with poor prognosis and low quality of life in breast cancer patients. Therefore, the primary diagnosis of liver metastatic lesions in breast cancer patients is very important. In this study, the ability of biochemical markers CA153, CEA, and ALP to be used for prognostic liver metastasis in women with breast cancer was investigated. Methods: 306 women with breast cancer recorded between 2008 and 2012 were included. Serum concentrations of alkaline phosphatase (ALP), carcinogenicity antigen (CEA), cancer antigen (CA-153), age, menopausal status, histologic type, tumor size and number of cancerous axillary lymph nodes in two groups of breast cancer women with liver metastases and without it were studied. To identify independent liver metastasis prognostic factors, logistic regression method was applied. Results: The independent prognostic factors of liver metastases in women with breast cancer are ALP, CEA, age, menopausal status, number of cancerous axillary lymph nodes and tumor size. Sensitivity and specificity analysis showed that CEA with a cutoff value of 1.1 was the most accurate predictive factor. Conclusion: The increase in the levels of CEA and ALP can be diagnostic markers for liver metastases from breast cancer.

Sign in / Sign up

Export Citation Format

Share Document