Prognostic value of DNA flow cytometry in the locally recurrent, conservatively treated breast cancer patient.

1992 ◽  
Vol 10 (12) ◽  
pp. 1839-1847 ◽  
Author(s):  
B G Haffty ◽  
M Toth ◽  
S Flynn ◽  
D Fischer ◽  
D Carter
Keyword(s):  
Breast Cancer ◽  
Flow Cytometry ◽  
Survival Rate ◽  
Local Recurrence ◽  
Dna Ploidy ◽  
Disease Free Survival ◽  
Dna Flow Cytometry ◽  
Free Survival ◽  
Locally Recurrent ◽  
Disease Free

PURPOSE This study attempted to determine the prognostic value of DNA flow cytometry in the treatment of patients with locally recurrent, conservatively treated breast cancer. METHODS AND MATERIALS Of 433 patients with clinical stage I and II breast cancer treated with conservative surgery and radiotherapy at Yale-New Haven Hospital before January 1985, 50 patients experienced an ipsilateral breast relapse as a first site of treatment failure. Using standard flow-cytometric techniques, DNA ploidy, DNA index, and S-phase fraction (SPF) were measured for 38 of the 50 (76%) paraffin-embedded specimens available for analysis. RESULTS At a median postrecurrence follow-up of 5.8 years, the 5-year and disease-free survival rates following ipsilateral breast treatment failure were 48% and 54%, respectively. Sixty-three percent of the recurrent tumors were DNA diploid and 37% were aneuploid. Both DNA ploidy and SPF were statistically significant prognostic indicators for 5-year survival and disease-free survival after local recurrence. The 5-year survival rate of the DNA diploid population was 64%, compared with 15% in the aneuploid population (P < .02). Patients with low SPF (< 12%) experienced an 83% 5-year survival rate, compared with a 24% 5-year survival rate in patients with high SPF (> or = 12%) (P < .03). Ploidy and SPF were combined to define the categories of favorable (diploid, low SPF) and unfavorable (diploid, high SPF or any aneuploid subgroups). Patients in the favorable category experienced an 89% 5-year postrecurrence survival rate and a 100% disease-free survival rate, whereas patients in the unfavorable category had a 24% 5-year survival rate and a 32% disease-free survival rate (P < .01). The flow cytometry as a factor correlated with other clinical parameters previously shown to be of prognostic significance in this patient population. In a multivariate analysis, flow cytometry was a statistically significant and independent prognostic factor for disease-free survival following local recurrence. CONCLUSIONS DNA ploidy and SPF as measured by currently available flow-cytometric techniques show promise as a tool in determining prognosis for the patient with locally recurrent breast cancer. Implications of these findings with respect to issues of adjuvant systemic therapy at the time of local recurrence are discussed.

DNA Flow Cytometry but Not Telomerase Activity as Predictor of Disease-Free Survival in pT1–2/N0/G2 Breast Cancer

Pathobiology ◽  
2006 ◽  
Vol 73 (2) ◽  
pp. 63-70 ◽  
Author(s):  
António E. Pinto ◽  
Saudade André ◽  
Teresa Pereira ◽  
Giovani Silva ◽  
Jorge Soares
Keyword(s):  
Breast Cancer ◽  
Flow Cytometry ◽  
Disease Free Survival ◽  
Telomerase Activity ◽  
Dna Flow Cytometry ◽  
Free Survival ◽  
Disease Free

scholarly journals Local Disease-Free Survival Rate (LSR) Application to Personalize Radiation Therapy Treatments in Breast Cancer Models

2020 ◽  
Vol 10 (4) ◽  
pp. 177
Author(s):  
Gaetano Savoca ◽  
Marco Calvaruso ◽  
Luigi Minafra ◽  
Valentina Bravatà ◽  
Francesco Paolo Cammarata ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Survival Rate ◽  
Treatment Plan ◽  
Disease Free Survival ◽  
Breast Epithelial Cell ◽  
Free Survival ◽  
Local Disease ◽  
Intrinsic Radiosensitivity ◽  
Disease Free Survival Rate ◽  
Disease Free

Cancer heterogeneity represents the main issue for defining an effective treatment in clinical practice, and the scientific community is progressively moving towards the development of more personalized therapeutic regimens. Radiotherapy (RT) remains a fundamental therapeutic treatment used for many neoplastic diseases, including breast cancer (BC), where high variability at the clinical and molecular level is known. The aim of this work is to apply the generalized linear quadratic (LQ) model to customize the radiant treatment plan for BC, by extracting some characteristic parameters of intrinsic radiosensitivity that are not generic, but may be exclusive for each cell type. We tested the validity of the generalized LQ model and analyzed the local disease-free survival rate (LSR) for breast RT treatment by using four BC cell cultures (both primary and immortalized), irradiated with clinical X-ray beams. BC cells were chosen on the basis of their receptor profiles, in order to simulate a differential response to RT between triple negative breast and luminal adenocarcinomas. The MCF10A breast epithelial cell line was utilized as a healthy control. We show that an RT plan setup based only on α and β values could be limiting and misleading. Indeed, two other parameters, the doubling time and the clonogens number, are important to finely predict the tumor response to treatment. Our findings could be tested at a preclinical level to confirm their application as a variant of the classical LQ model, to create a more personalized approach for RT planning.

scholarly journals Evaluation of the response rate of chemo-radiation and brachytherapy in patients with locally advanced carcinoma cervix in a tertiary care center

2020 ◽  
Vol 8 (4) ◽  
pp. 1361
Author(s):  
Sukanya Semwal ◽  
Jaskaran S. Sethi ◽  
Munish Gairola ◽  
David K. Simson ◽  
Rajendra Kumar ◽  
...  
Keyword(s):  
Survival Rate ◽  
Local Recurrence ◽  
Tertiary Care ◽  
Locally Advanced ◽  
Disease Free Survival ◽  
Distant Metastases ◽  
Carcinoma Cervix ◽  
Free Survival ◽  
Advanced Carcinoma ◽  
Disease Free

Background: Incidence and mortality estimates are used to measure the burden of cancer in a population and survival estimates are ideal for evaluating the outcome of cancer control activities. Survival studies evaluate the quality and quantity of life of a group of patients after diagnosing the disease. The patient survival after the diagnosis of cervical cancer is indirectly influenced by socio-economic factors. The present study was carried out with an aim to evaluate the success rate of chemo-radiation followed by brachytherapy to the patients of locally advanced carcinoma (Ca.) cervix in a tertiary care center.Methods: All cases were staged according to the International Federation of Gynaecologists and Oncologists (FIGO) staging system. To illustrate the observed survival of cancer patients Kaplan-Meier curve was plotted. All the patients, except one, completed chemo-radiation and were retrospectively analyzed for the presence of local residual disease, local recurrence, distant metastases, radiation reactions, disease-free survival, and overall survival.Results: There were 22 patients of Carcinoma cervix reported in the radiation oncology department in the year 2018 and 2019. The overall treatment time ranged from 30 days to 178 days, with a median of 63 days. All the patients had a complete response after the treatment. The median follow-up time for all the patients was 15 months. Three patients had a metastatic recurrence and one patient developed distant metastases as well as local recurrence. Overall survival rate was 100% while the disease-free survival rate was 81.82%.Conclusions: The response to chemo-radiation in the treatment of locally advanced Carcinoma cervix is comparable to historic data and is well tolerated.

scholarly journals SPECIAL APPROACHES TO BREAST CANCER HORMONAL THERAPY OF YOUNG PATIENTS

2016 ◽  
Vol 7 (2) ◽  
pp. 15-20
Author(s):  
D N Kravchenko ◽  
A A Parokonnaya ◽  
M I Nechushkin ◽  
D E Avtomonov
Keyword(s):  
Breast Cancer ◽  
Survival Rate ◽  
Young Patients ◽  
Disease Free Survival ◽  
Free Survival ◽  
Ovarian Suppression ◽  
Prognostic Features ◽  
Disease Free Survival Rate ◽  
Disease Free

Breast cancer is the most prevalent female malignancy. When diagnosed at young age (up to 40 years), negative clinical, morphological and prognostic features are noted. A non-randomized retrospective trial (n=500) was performed to evaluate different scenarios of breast cancer hormone therapy in young patients. Ovarian suppression in young patients is shown to statistically improve prognosis. Disease-free survival rate values are observed to decrease in patients without ovarian suppression in comparison with any type of ovarian suppression, especially at a remote follow-up (after 60 months). Menstrual function resumption and no amenorrhea after chemotherapy significantly decrease disease-free survival rate values in young patients.

Single-center experiences of neoadjuvant systemic therapy in breast cancer: Individualization of the treatment

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. e11628-e11628
Author(s):  
M. Gumus ◽  
B. O. Ustaalioglu ◽  
M. Seker ◽  
A. Bilici ◽  
T. Salman ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Overall Survival ◽  
Survival Rate ◽  
Neoadjuvant Chemotherapy ◽  
Distant Metastasis ◽  
Locally Advanced Breast Cancer ◽  
Locally Advanced ◽  
Disease Free Survival ◽  
Free Survival ◽  
Disease Free

e11628 Background: Neoadjuvant chemotherapy is one of the standard treatment options for patients with locally advanced breast cancer for twenty five years. In this study, we evaluate results of neoadjuvant chemotherapy in breast cancer patients. Methods: We retrospectively analyzed 68 patients with locally advanced breast cancer. Anthracycline/taxane-based chemotherapy regimens were prescribed mostly for neoadjuvant chemotherapy. Before chemotherapy was given, patients were examined for distant metastasis by radiologic methods thereafter if patient had distant metastasis, they were excluded. Patients with breast cancer received neoadjuvant chemotherapy were analyzed according to age, menopausal status, type of surgery, response to the treatment, histopathological properties and survival. After 3 to 6 cycle of chemotherapy patients were reevaluated by clinically and radiologically for response. Surgery was performed for appropriate patient thereafter adjuvant locoregional and systemic chemotherapy were continued. Results: Median age was 47 (29–43) years. 17,6 % of them were younger than 35 years and 42,6 % were premenopausal. Median follow-up time was 19 month. After 3 to 6 cycle of neoadjuvant chemotherapy 64 of patients responded to therapy (94,1 %). Breast conserving surgery was performed for 15,6 % patients. In histopathologic analysis most of patients were invasive ductal carcinoma and there was lymph node invasion for 84,9 %. Estrogen and progesterone receptor status were negative for 18,6 % of patients and cerbB2 was positive for 14,8 % of patients. Median disease free survival time was 44 month (SE: 9; 95% CI: 25–62) but median overall survival time could not be reached. Three years disease free survival rate and overall survival rate were 55,3% and 90,1% respectively. According to Cox regression analyses; we did not find any demographic and pathologic characteristic of breast cancer that is related to prognosis. Conclusions: In recent years neoadjuvant chemotherapy in breast cancer is increasingly being used for early stage disease. Further study will be facilitated establishment of guidelines for preselecting patients for neoadjuvant chemotherapy and will provide beneficial effect on treatment option and survival. No significant financial relationships to disclose.

Is Surgery Necessary After Complete Clinical Remission Following Neoadjuvant Chemotherapy for Early Breast Cancer?

2003 ◽  
Vol 21 (24) ◽  
pp. 4540-4545 ◽  
Author(s):  
A. Ring ◽  
A. Webb ◽  
S. Ashley ◽  
W.H. Allum ◽  
S. Ebbs ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Overall Survival ◽  
Local Recurrence ◽  
Neoadjuvant Chemotherapy ◽  
Disease Free Survival ◽  
Free Survival ◽  
Surgery Group ◽  
Complete Clinical Remission ◽  
Radiotherapy Alone ◽  
Disease Free

Purpose: This retrospective analysis aimed to identify whether breast cancer patients receiving radiotherapy alone following a complete clinical remission (cCR) to neoadjuvant chemotherapy had a worse outcome than those treated with surgery. Patients and Methods: One hundred thirty-six patients who had achieved a cCR to neoadjuvant chemotherapy for early breast cancer were identified from a prospectively maintained database of 453 patients. Of these, 67 patients had undergone surgery as their primary locoregional therapy, and 69 patients had radiotherapy alone. Outcome was assessed in relation to local recurrence-free survival, disease-free survival, and overall survival. Results: Median follow-up was 63 months in the surgery group and 87 months in the no surgery group. Prognostic characteristics were well balanced between the two groups. For surgery and no surgery, respectively, there were no significant differences in disease-free survival or overall survival (5-year, 74% v 76%; 10-year, 60% v 70%, P = .9) between the two groups. There was a nonsignificant trend toward increased locoregional-only recurrence for the no surgery group (21% v 10% at 5 years; P = .09), but no long-term failures of local control. Patients in the no surgery group who also achieved an ultrasound complete remission had a 5-year local recurrence rate of only 8%. Conclusion: In patients achieving a cCR to neoadjuvant chemotherapy, radiotherapy alone achieve survival rates as good as with surgery, but with higher local recurrence rates. Ultrasound may identify a low recurrence rate subgroup for assessing no surgery in a prospective trial.

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