Identification of a subgroup of patients with breast cancer and histologically positive axillary nodes receiving adjuvant chemotherapy who may benefit from postoperative radiotherapy.

1988 ◽  
Vol 6 (7) ◽  
pp. 1107-1117 ◽  
Author(s):  
B Fowble ◽  
R Gray ◽  
K Gilchrist ◽  
R L Goodman ◽  
S Taylor ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Adjuvant Chemotherapy ◽  
Tumor Size ◽  
Primary Tumor ◽  
Postoperative Radiotherapy ◽  
Eastern Cooperative Oncology Group ◽  
Distant Metastases ◽  
Primary Tumor Size ◽  
Axillary Nodes ◽  
Postmastectomy Radiation

Risk factors for isolated local-regional (LR) recurrence following mastectomy for breast cancer were analyzed in a review of 627 women entered into Eastern Cooperative Oncology Group (ECOG) adjuvant chemotherapy trials between 1978 and 1982. Premenopausal patients were randomized to cyclophosphamide, methotrexate, and fluorouracil (5-FU) (CMF), cyclophosphamide, methotrexate, 5-FU, and prednisone (CMFP), or cyclophosphamide, methotrexate, 5-FU, prednisone, and tamoxifen (CMFPT). Postmenopausal patients were randomized to observation, CMFP, or CMFPT. Median follow-up time was 4.5 years. At 3 years, 225 patients relapsed and in 70 (31% of failures, 11% of all patients) the initial site was LR without distant metastases. In a multivariate analysis, the risk of an isolated LR recurrence significantly correlated with the number of positive axillary nodes, the primary tumor size, the presence of tumor necrosis, and the number of axillary nodes examined. Factors that significantly discriminated between an isolated LR recurrence and distant metastasis were the number of positive nodes and primary tumor size. Patients with four to seven positive nodes or tumor size greater than or equal to 5 cm had a chance of developing an isolated LR recurrence almost equal to the risk of distant metastases. These findings suggest a potential for improved survival in this subset of patients with the addition of postmastectomy radiation to chemotherapy, and continue to emphasize the presence of a group of patients at high risk for isolated LR recurrence despite adjuvant chemotherapy.

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

A nomogram to predict nonsentinel lymph node involvement in breast cancer patients with sentinel lymph node metastases.

2011 ◽  
Vol 29 (27_suppl) ◽  
pp. 14-14
Author(s):  
Y. Kojima ◽  
K. Tsugawa ◽  
K. Enokido ◽  
H. Iwata ◽  
S. Ohno ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Multivariate Analysis ◽  
Lymph Node ◽  
Cancer Patients ◽  
Predictive Factors ◽  
Tumor Size ◽  
Primary Tumor ◽  
Lymphatic Invasion ◽  
Breast Cancer Patients ◽  
Primary Tumor Size

14 Background: Several nomograms have been described as predictors of non-sentinel axially lymph node (non-SN) metastases in breast cancer with positive sentinel nodes (SN). However, all these predicting models were based on data from western countries. The purpose of this study was to examine predictive factors of non-SN status among SN metastatic patients, in order to develop a nomogram based on Japanese large data set. Methods: This research was analyzed by using a clinical database of 11,228 Japanese breast cancer patients who registerd to cohort study as SN biopsy between March 2008 and Octover 2009 in Japan. We reviewed data retrospectively to extract patients with SN metastases who underwent complementary axillary lymph node dissection. In this cohort, we examined predictive factors of non-SN metastases. All clinical and pathologic features were analyzed to predict the non-SN status, by using univariate and multivariate logistic regression model. A receiver operating characteristic curve was constructed and the area under the curve (AUC) was calculated. Results: Among the database, SN metastases were found in 1,029 patients, and 345 (33.5%) were non-SN positive. Univariate analysis showed a significant association between non-SN involvement and primary tumor size (p<0.001), histologic grade (p=0.011), lymphatic invasion (p<0.001), venous invasion (p=0.005) and the number of involved SNs among all identified SNs (p<0.001). Tumor size (p<0.001), lymphatic invasion (p<0.001), and the size of SN metastasis (p<0.001) were associated with non-SN metastasis in multivariate analysis. Based on the multivariate analysis, we developed a scoring system to predict the likelihood of non-SN metastases in breast cancer patients with SN involvement. The discriminatory ability of our nomogram, as measured by the AUC, was 0.752. Conclusions: In patients with invasive breast cancer and a positive SN, primary tumor size, lymphatic invasion, and the size of SN metastases among all identified SNs were independently predictive of non-SN involvement, and used for a nomogram. Validation study will be performed in the future investigation.

Impact of primary tumor size/horizontal extent on survival in colorectal cancer.

2021 ◽  
Vol 39 (3_suppl) ◽  
pp. 125-125
Author(s):  
Olatunji B. Alese ◽  
Wei Zhou ◽  
Renjian Jiang ◽  
Katerina Mary Zakka ◽  
Walid Labib Shaib ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Adjuvant Chemotherapy ◽  
Tumor Size ◽  
Primary Tumor ◽  
Survival Rates ◽  
Stage I ◽  
Stage Ii ◽  
Stage Iii ◽  
Primary Tumor Size ◽  
The Impact

125 Background: Pathologic staging in colorectal cancer (CRC) is crucial in patient management. Data regarding the impact of size/horizontal tumor extent is limited, contradictory and currently excluded from the American Joint Committee on Cancer (AJCC) staging model. However, a previously published SEER analysis showed that AJCC stages I and IIIA have similar 2- and 5- year survival rates, and worse rates for stage II. Using the largest cohort to date, we report the impact of primary tumor size on CRC survival. Methods: Data were obtained from all US hospitals that contributed to the National Cancer Database (NCDB) between 2010 and 2015. Univariate and multivariate analyses were performed to identify factors associated with patient outcome. Kaplan-Meier analysis and Cox proportional hazards models were used to assess the association between tumor/patient characteristics and overall survival (OS). Results: A total of 61,145 patients were identified with a similar gender distribution (M/F:50.9%/49.1%). The mean age was 62.7years (SD+/-14.1) and 82% were non-Hispanic Whites. Majority had colon primary (82.7%) and 82.4% had microsatellite stable (MSS) disease. Distribution across stages I-IV was 20.1%, 32.1%, 34.7% and 13.2% respectively. Among the total study population, AJCC stage correlated closely with OS on multivariate analysis (HR 1.49, 2.29, 8.38 for stages II to IV compared to stage I), while the distinguishing power for tumor size was relatively mild (HR 1.19 and 1.33 for 5-10 cm and >5cm compared to <5cm). Among patients with stage II disease, tumors >10cm were associated with worse survival compared to those <5cm (HR 1.2; 1.03-1.39; p=0.22). Stage III disease also had differential survival rates; patients with tumors 5-10cm (HR 1.21; 1.14-1.28; p<0.001) and >10cm (HR 1.57; 1.37-1.80; p<0.001) had worse survival than those <5cm. Patients with stage II who did not receive adjuvant chemotherapy (CTX) had worse survival outcomes (HR 1.29; 1.08-1.55; p=0.005) compared to stage III disease who did. Accounting for tumor size, there was no statistically significant survival differences between stage I patients and stages II and III patients who received adjuvant chemotherapy. Conclusions: Tumors larger than 10cm have inferior outcomes among patients in the same AJCC stages. Stage II patients without adjuvant CTX did worse than stage III with CTX. Further studies are needed to clarify the role of tumor size in staging models. [Table: see text]

scholarly journals The role of postoperative radiotherapy after radical mastectomy in treatment of early breast cancer

2002 ◽  
Vol 10 (1) ◽  
pp. 7-12
Author(s):  
Jasmina Mladenovic ◽  
Nenad Borojevic
Keyword(s):  
Breast Cancer ◽  
Survival Rate ◽  
Adjuvant Chemotherapy ◽  
Local Recurrence ◽  
Postoperative Radiotherapy ◽  
Radical Mastectomy ◽  
Distant Metastases ◽  
Regional Lymph Nodes ◽  
Postoperative Irradiation

BACKGROUND: Radical or modified radical mastectomy was considered for many years the standard therapy for operable patients. Following radical mastectomy, postoperative irradiation of the chest wall and peripheral lymphatics is indicated in selected highrisk patients. Some studies on breast cancer patients who underwent radical mastectomy and received adjuvant chemotherapy tried to find out whether the addition of irradiation treatment to the chest wall and regional lymph nodes increases survival. The hypothesis in favor of irradiation is that chemotherapy can eliminate distant micrometastases, but is less effective against local and regional diseases, which are better controlled by radiotherapy. METHODS: In one year period, 110 patients with early stage of breast cancer were treated with radical mastectomy, and postoperative radiotherapy. Forty one patients had only postoperative radiotherapy, 27 received also adjuvant chemotherapy, 40 received adjuvant hormonal therapy and 2 patients received both adjuvant chemo and hormonotherapy. Postoperative irradiation was given on the regional lymph nodes (supra and infraclavicular, axillary and internal mammary nodes) with the tumor dose 48 Gy in 22 fractions over a period of four and a half weeks. All fields were treated with Cobalt 60. RESULTS After the median follow up of 67 months, 33 patients (30 %) had some kind of failure in form of local recurrence, distant metastases or both Locoregional relapse alone or associated with distant metastases occurred in 10 patients (9.1 %). Only 1.8 % of patients had local recurrence as the first failure. Distant metastases occurred in 32 patients (29.1%). After the end of follow up, 60 % patients are alive without evidence of disease while 16.4 % patients are alive with disease. The 5 year overall survival rate was 78.19% and 5 year disease free survival rate was 67.44%. CONCLUSION: Postoperative radiotherapy after radical mastectomy has important role in adjuvant treatment of early breast cancer in combination with adjuvant chemotherapy and hormonotherapy.

scholarly journals ВОЗМОЖНОСТИ РЕНТГЕНОВСКОЙ МАММОГРАФИИ "МАЛЫХ" ФОРМ РАКА МОЛОЧНОЙ ЖЕЛЕЗЫ НА ФОНЕ ФИБРОЗНО-КИСТОЗНОЙ БОЛЕЗНИ

2014 ◽  
Vol 13 (1) ◽  
pp. 27-30
Author(s):  
D. G. Bukharin ◽  
S. A. Velichko ◽  
I. G. Frolova
Keyword(s):  
Breast Cancer ◽  
Tumor Size ◽  
Primary Tumor ◽  
Conventional Approach ◽  
Diagnostic Process ◽  
Breast Lesions ◽  
Concomitant Disease ◽  
Fibrocystic Disease ◽  
Cancer Symptoms ◽  
Primary Tumor Size

The analysis of radiologic signs of small size breast cancer in patients with fibrocystic disease has been carried out.The conventional approach to the analysis of mammograms of these patients based on the detection of primary, secondary and indirect cancer symptoms has been found to have insufficient effect.The relationship between mammographic findings and primary tumor size, character and concomitant disease intensity has been proved.The data obtained allow us to arrange the diagnostic process and management of patients with breast lesions.

Axillary Lymph Nodes: US-guided Fine-Needle Aspiration for Initial Staging of Breast Cancer—Correlation with Primary Tumor Size

Radiology ◽  
2008 ◽  
Vol 246 (1) ◽  
pp. 81-89 ◽  
Author(s):  
Susan L. Koelliker ◽  
Maureen A. Chung ◽  
Martha B. Mainiero ◽  
Margaret M. Steinhoff ◽  
Blake Cady
Keyword(s):  
Breast Cancer ◽  
Fine Needle Aspiration ◽  
Tumor Size ◽  
Primary Tumor ◽  
Needle Aspiration ◽  
Axillary Lymph Nodes ◽  
Axillary Lymph ◽  
Primary Tumor Size ◽  
Fine Needle ◽  
Initial Staging
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