scholarly journals Loco-regional recurrence trend and prognosis in young women with breast cancer according to molecular subtypes: analysis of 1099 cases

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Yang Li ◽  
Su Lu ◽  
Yuhan Zhang ◽  
Shuaibing Wang ◽  
Hong Liu
Keyword(s):  
Breast Cancer ◽  
Local Recurrence ◽  
Molecular Subtypes ◽  
Early Stage ◽  
Young Patients ◽  
Distant Metastases ◽  
Early Stage Breast Cancer ◽  
Regional Recurrence ◽  
Her2 Status ◽  
Over Time

Abstract Background The number of young patients diagnosed with breast cancer is on the rise. We studied the rate trend of local recurrence (LR) and regional recurrence (RR) in young breast cancer (YBC) patients and outcomes among these patients based on molecular subtypes. Methods A retrospective cohort study was conducted based on data from Tianjin Medical University Cancer Institute and Hospital for patients ≤ 35 years of age with pathologically confirmed primary invasive breast cancer surgically treated between 2006 and 2014. Patients were categorized according to molecular subtypes on the basis of hormone receptor (HR) and human epidermal growth factor receptor 2 (HER2) status. The 5-year rates for LR, RR, and distant metastases (DM) were estimated by Kaplan-Meir statistics. Nelson-Aalen cumulative-hazard plots were used to describe local recurrence- and distant metastasis-free intervals. Results We identified 25,284 patients with a median follow-up of 82 months, of whom 1099 (4.3%) were YBC patients ≤ 35 years of age. The overall 5-year LR, RR, and DM rates in YBC patients were 6.7%, 5.1%, and 16.6%, respectively. The LR and RR rates demonstrated a decreasing trend over time (P = 0.028 and P = 0.015, respectively). We found that early-stage breast cancer and less lymph node metastases increased over time (P = 0.004 and P = 0.007, respectively). Patients with HR−/HER2+ status had a significantly higher LR (HR 20.4; 95% CI, 11.8–35.4) and DM (HR 37.2; 95% CI, 24.6–56.3) at 10 years. Breast-conserving surgery (BCS) or mastectomy did not influence rates of LR and RR. In the overall population, the 5-year survival of YBC patients exceeded 90%. Conclusions The rates of LR and RR with YBC patients demonstrated a downward trend and the proportion of early-stage breast cancer increased between 2006 and 2014. We report the highest LR rates in this young population were associated with HR−/HER2+ tumors.

Loco-regional recurrence trend and prognosis in young women with breast cancer according to molecular subtypes ： analysis of 1099 cases

2021 ◽  
Author(s):  
Yang Li ◽  
Su Lu ◽  
Yuhan Zhang ◽  
Shuaibing Wang ◽  
Hong Liu
Keyword(s):  
Breast Cancer ◽  
Local Recurrence ◽  
Molecular Subtypes ◽  
Early Stage ◽  
Young Patients ◽  
Distant Metastases ◽  
Early Stage Breast Cancer ◽  
Regional Recurrence ◽  
Her2 Status ◽  
Over Time

Abstract BackgroundThe number of young patients diagnosed with breast cancer is on the rise. We studied the rate trend of local recurrence (LR) and regional recurrence (RR) in young breast cancer (YBC) patients and outcomes among these patients based on molecular subtypes. Methods A retrospective cohort study was conducted based on data from Tianjin Medical University Cancer Institute and Hospital for patients ≤35 years of age with pathologically-confirmed primary invasive breast cancer surgically treated between 2006 and 2014. Patients were categorized according to molecular subtypes on the basis of hormone receptor (HR) and human epidermal growth factor receptor 2 (HER2) status. The 5-year rates for LR, RR, and distant metastases (DM) were estimated by Kaplan-Meir statistics. Nelson-Aalen cumulative-hazard plots were used to describe local recurrence- and distant metastases-free intervals. ResultsWe identified 25,284 patients with a median follow-up of 82 months, of whom 1099 (4.3%) were YBC patients ≤35 years of age. The overall 5-year LR, RR and DM rates in YBC patients were 6.7%, 5.1%, and 16.6%, respectively. The LR and RR rates demonstrated a decreasing trend over time (P=0.028 and P=0.015, respectively). We found that early-stage breast cancer and less lymph node metastases increased over time (P=0.004 and P=0.007, respectively). Patients with HR-/HER2+ status had a significantly higher LR (HR 20.4; 95% CI,11.8-35.4) and DM (HR 37.2; 95% CI, 24.6-56.3) at 10 years. Breast conserving surgery (BCS) or mastectomy did not influence rates of LR and RR. In the overall population, the 5-year survival of YBC patients exceeded 90%. ConclusionsThe rates of LR and RR with YBC patients demonstrated a downward trend and the proportion of early-stage breast cancer increased between 2006 and 2014. We report the highest LR rates in this young population were associated with HR-/HER2+ tumors in absence of standard treatment.

scholarly journals Loco-Regional Recurrence Trend and Prognosis in Young Women With Breast Cancer According to Molecular Subtypes

2020 ◽  
Author(s):  
Yang Li ◽  
Su Lu ◽  
Yuhan Zhang ◽  
Shuaibing Wang ◽  
Hong Liu
Keyword(s):  
Breast Cancer ◽  
Local Recurrence ◽  
Molecular Subtypes ◽  
Early Stage ◽  
Young Patients ◽  
Distant Metastases ◽  
Early Stage Breast Cancer ◽  
Regional Recurrence ◽  
Her2 Status ◽  
Over Time

Abstract Purpose The number of young patients diagnosed with breast cancer is on the rise. We studied the rate trend of local recurrence (LR) and regional recurrence (RR) in young breast cancer (YBC) patients and outcomes among these patients based on molecular subtypes. Methods A retrospective cohort study was conducted based on data from Tianjin Medical University Cancer Institute and Hospital for patients ≤35 years of age with pathologically-confirmed primary invasive breast cancer surgically treated between 2006 and 2014. Patients were categorized according to molecular subtypes on the basis of hormone receptor (HR) and human epidermal growth factor receptor 2 (HER2) status. The 5-year rates for LR, RR, and distant metastases were estimated by Kaplan-Meir statistics. Nelson-Aalen cumulative-hazard plots were used to describe local recurrence- and distant metastases-free intervals. Results We identified 25,284 patients with a median follow-up of 82 months, of whom 1099 (4.3%) were YBC patients ≤35 years of age. The overall 5-year local, regional, and distant recurrence rates in YBC patients were 6.7%, 5.1%, and 16.6%, respectively. The LR and RR rates demonstrated a decreasing trend over time (P=0.028 and P=0.015, respectively). We found that early-stage breast cancer and less lymph node metastases increased over time (P=0.004 and P=0.007, respectively). Patients with HR-/HER2+ status had a significantly higher LR (HR 20.4; 95% CI,11.8-35.4) and DM (HR 37.2; 95% CI, 24.6-56.3) at 10 years. In the overall population, the 5-year survival of YBC patients exceeded 90%. Conclusion The rates of LR and RR with YBC patients demonstrated a downward trend and the proportion of early-stage breast cancer increased between 2006 and 2014. We report that the outcomes varied with molecular subtypes and patients with HR-/HER2+ status had the worst survival.

scholarly journals Health-related quality of life of early-stage breast cancer patients after different radiotherapy regimens

2021 ◽  
Author(s):  
Daphne H. M. Jacobs ◽  
Ramona K. Charaghvandi ◽  
Nanda Horeweg ◽  
John H. Maduro ◽  
Gabrielle Speijer ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Quality Of Life ◽  
Early Stage ◽  
Early Stage Breast Cancer ◽  
Breast Irradiation ◽  
Health Related Quality ◽  
Related Quality ◽  
Health Related ◽  
Over Time

Abstract Purpose To evaluate and compare health-related quality of life (HRQL) of women with early-stage breast cancer (BC) treated with different radiotherapy (RT) regimens. Methods Data were collected from five prospective cohorts of BC patients treated with breast-conserving surgery and different RT regimens: intraoperative RT (IORT, 1 × 23.3 Gy; n = 267), external beam accelerated partial breast irradiation (EB-APBI, 10 × 3.85 Gy; n = 206), hypofractionated whole breast irradiation(hypo-WBI, 16 × 2.67 Gy; n = 375), hypo-WBI + boost(hypo-WBI-B, 21–26 × 2.67 Gy; n = 189), and simultaneous WBI + boost(WBI-B, 28 × 2.3 Gy; n = 475). Women ≥ 60 years with invasive/in situ carcinoma ≤ 30 mm, cN0 and pN0-1a were included. Validated EORTC QLQ-C30/BR23 questionnaires were used to asses HRQL. Multivariable linear regression models adjusted for confounding (age, comorbidity, pT, locoregional treatment, systemic therapy) were used to compare the impact of the RT regimens on HRQL at 12 and 24 months. Differences in HRQL over time (3–24 months) were evaluated using linear mixed models. Results There were no significant differences in HRQL at 12 months between groups except for breast symptoms which were better after IORT and EB-APBI compared to hypo-WBI at 12 months (p < 0.001). Over time, breast symptoms, fatigue, global health status and role functioning were significantly better after IORT and EB-APBI than hypo-WBI. At 24 months, HRQL was comparable in all groups. Conclusion In women with early-stage breast cancer, the radiotherapy regimen did not substantially influence long-term HRQL with the exception of breast symptoms. Breast symptoms are more common after WBI than after IORT or EB-APBI and improve slowly until no significant difference remains at 2 years posttreatment.

Patient preferences concerning the trade-off between the risks and benefits of routine radiation therapy after conservative surgery for early-stage breast cancer.

1997 ◽  
Vol 15 (3) ◽  
pp. 1252-1260 ◽  
Author(s):  
J A Hayman ◽  
D L Fairclough ◽  
J R Harris ◽  
J C Weeks
Keyword(s):  
Breast Cancer ◽  
Radiation Therapy ◽  
Local Recurrence ◽  
Early Stage ◽  
Conservative Surgery ◽  
Sociodemographic Factors ◽  
Early Stage Breast Cancer ◽  
Health States ◽  
Trade Off ◽  
Risks And Benefits

PURPOSE To assess patients' preferences regarding the trade-off between risks and benefits of radiation therapy after conservative surgery for early-stage breast cancer. PATIENTS AND METHODS Utilities (measures of preference) of 97 early-stage breast cancer patients treated with conservative surgery and radiation therapy and 20 medical oncology nurses were assessed for five health states using standard gambles. RESULTS Patients had the highest mean utility for treatment with conservative surgery and radiation therapy without a local recurrence (0.92), intermediate utilities for treatment with conservative surgery alone followed either by no local recurrence or by a local recurrence salvaged by conservative surgery and radiation therapy (0.88 and 0.87, respectively), and the lowest utilities for treatment with or without radiation therapy followed by a local recurrence salvaged by mastectomy and reconstructive surgery (0.82 and 0.81, respectively). All differences between health states' utilities were significant (P < .0001), except between the two intermediate and two lowest rated health states. None of the clinical or sociodemographic factors examined explained more than 5% of the variability in the patients' utilities or their differences. Nurses' utilities were similar to those of the patients. CONCLUSIONS These results strongly suggest that fear of a local recurrence and an actual local recurrence leading to mastectomy have such a negative impact on quality of life that patients are willing to accept the risks and inconvenience of radiation therapy to avoid them. There is also considerable interpatient variability that was not explained by the clinical or sociodemographic factors examined.

Outcome Following Local-Regional Recurrence in Women with Early-Stage Breast Cancer: Impact of Biologic Subtype

2015 ◽  
Vol 21 (2) ◽  
pp. 161-167 ◽  
Author(s):  
Lior Z. Braunstein ◽  
Andrzej Niemierko ◽  
Mina N. Shenouda ◽  
Linh Truong ◽  
Betro T. Sadek ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Early Stage ◽  
Early Stage Breast Cancer ◽  
Regional Recurrence ◽  
Biologic Subtype ◽  
Local Regional Recurrence
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