Does administration of chemotherapy before radiotherapy in breast cancer patients treated with conservative surgery negatively impact local control?

1995 ◽  
Vol 13 (12) ◽  
pp. 2906-2915 ◽  
Author(s):  
C E Leonard ◽  
M E Wood ◽  
B Zhen ◽  
J Rankin ◽  
D A Waitz ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Adjuvant Chemotherapy ◽  
Local Recurrence ◽  
Lymph Nodes ◽  
Cancer Patients ◽  
Conservative Surgery ◽  
Breast Cancer Patients ◽  
Group I ◽  
Group Ii ◽  
Prolonged Surgery

PURPOSE To determine if a delay of irradiation to the intact breast for administration of adjuvant chemotherapy results in increased local recurrence in breast cancer. PATIENTS AND METHODS The records of 262 women with 264 cases of breast cancer were reviewed. Group I contained 105 patients treated with conservative surgery, chemotherapy, and radiotherapy. Group II contained 157 patients (used as a concurrent control) treated with conservative surgery and radiotherapy only. Eighty-nine percent of subjects in group I received all chemotherapy before radiotherapy. Fifty-eight percent of patients received hormone therapy. Seventy-one percent of patients had negative surgical margins, and 74% had negative lymph nodes. For group I, conservative surgery-radiotherapy intervals in months were less than 1 (five, 5%), > or = 1 to less than 3 (10, 9%), > or = 1 to less 6 (48, 46%), and > or = 6 (42, 40%), mean of 5. For group II, the intervals were less than 1 (20, 13%), > or = 1 to less than 3 (123, 79%), > or = 3 to less than 6 (11, 7%), and > or = 6 (two, 1%), mean of 1.5. RESULTS Thirty patients (11.5%) have disease recurrence (19 distant [6%] and 12 local [5%]). There were no significant differences in local recurrence (group I, four [4%]; group II, eight [5%]; difference not significant). There were no significant differences in local recurrence in any surgery-radiotherapy interval within each group. Although we found marginal increases in the percentage of local recurrences in group I patients (with prolonged surgery-radiotherapy intervals) who had positive margins, positive lymph nodes, and tumor size more than 2 cm versus group II (without prolonged surgery-radiotherapy intervals), these results were not significant. CONCLUSION We could not identify any surgery-radiotherapy interval that resulted in increased local recurrence if radiotherapy was delayed for administration of adjuvant chemotherapy in breast cancer patients. Because of the heterogenous population of breast cancer patients, our results also support the need for further study to determine the optimum integration of radiotherapy and chemotherapy in the management of the conservatively treated breast.

scholarly journals Sonographic Study of Female Pelvic Organs in Breast Cancer Patients Taking Tamoxifen: Clinical Correlation

2020 ◽  
Vol 7 (1) ◽  
pp. 17-23
Author(s):  
Rafia Parveen ◽  
Shaikh Shofiur Rahman ◽  
Taposhi Sarker ◽  
Syed Muhammad Baqui Billah ◽  
Zakir Hossain Habib
Keyword(s):  
Breast Cancer ◽  
Cancer Patients ◽  
Endometrial Thickness ◽  
Tamoxifen Therapy ◽  
Tamoxifen Treatment ◽  
Breast Cancer Patients ◽  
Group Iii ◽  
Group I ◽  
Group Ii ◽  
Uterine Volume

Background: As most of breast cancer patients are treated with Tamoxifen, different effects of this drug in patients should be evaluated since no such study is carried out in Bangladesh till date. Objective: The purpose of the present study was to evaluate sonographic changes of female genital organs in breast cancer patients treated with Tamoxifen and to correlate these changes with duration of Tamoxifen treatment and gynecological symptoms. Methodology: This randomized double-blind clinical trial was carried out in Delta Medical College Hospital, Dhaka, Bangladesh from May 2017 to April 2018 for a period of one (1) year. The participants were breast cancer patients which were divided into three groups named as group I patients. The patients of these group were on Tamoxifen therapy. The patients of group II were without Tamoxifen therapy. The patients of group III had completed Tamoxifen therapy. All participants underwent ultrasonography. Results: Patients receiving Tamoxifen therapy had significantly more thickened endometrium compared to other groups (26.6% in group I, 5% in group II and3% in group III). Similarly, abnormal sonographic findings and mean uterine volume were higher in group I compared to other two groups. Endometrial thickness and uterine volume showed significant positive correlation with duration of Tamoxifen therapy (p <0.0001). The endometrial thickness and uterine volume greatly increased after two years of Tamoxifen therapy while it was reverse in group III. Gynecological symptoms had no significant relations with sonographic abnormalities and thickened endometrium. Conclusion: Tamoxifen therapy is associated with increased endometrial thickness, uterine volume and abnormal sonographic findings, compared to patients without Tamoxifen or completing Tamoxifen therapy. Journal of Current and Advance Medical Research 2020;7(1): 17-23

Intermittent adjuvant chemotherapy as an alternative to improve survival in breast cancer patients with ten or more positive lymph nodes

2005 ◽  
Vol 23 (16_suppl) ◽  
pp. 906-906
Author(s):  
F. U. Lara medina ◽  
T. Ramirez-Ugalde ◽  
D. Flores-Estrada ◽  
A. Alvarado-Miranda ◽  
N. Castaneda soto ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Adjuvant Chemotherapy ◽  
Lymph Nodes ◽  
Cancer Patients ◽  
Breast Cancer Patients ◽  
Positive Lymph Nodes

Significant Changes in Circulating Plasma Levels of IGF1 and IGFBP3 after Conventional or Dose-Intensified Adjuvant Treatment of Breast Cancer Patients with one to three Positive Lymph Nodes

2007 ◽  
Vol 22 (3) ◽  
pp. 186-193 ◽  
Author(s):  
S. Kümmel ◽  
H. Eggemann ◽  
D. Lüftner ◽  
N. Gebauer ◽  
H. Bühler ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Growth Factor ◽  
Adjuvant Chemotherapy ◽  
Lymph Nodes ◽  
Cancer Patients ◽  
Plasma Levels ◽  
Binding Protein ◽  
Insulin Like Growth Factor ◽  
Breast Cancer Patients ◽  
Positive Lymph Nodes

The insulin-like growth factor 1 (IGF1) and its binding protein IGFBP3 (insulin-like growth factor binding protein 3) play a pivotal role during the growth and development of tissues. The purpose of this study was to evaluate the influence of anthracycline- and taxane-containing adjuvant chemotherapy in breast cancer patients on the circulating plasma levels of IGF1 and its main binding protein, IGFBP3. This investigation was part of a prospective randomized phase III study in which breast cancer patients were treated with either conventional or dose-intensified adjuvant chemotherapy. The factors were quantified in the plasma of 151 patients with a commercially available sandwich enzyme immunoassay. Before therapy, both parameters were within the normal range in most patients (n=145 and n=144). After therapy, both factors had increased significantly by 29% (IGF1) and 19% (IGFBP3), with the highest increase being observed in the dose-intensified group. Correlations with patient and tumor characteristics revealed a relatively higher increase in both parameters in premenopausal patients, patients with lower-grade tumors, more positive lymph nodes, larger tumor volume, and positive hormone receptor status. No correlation was found with the HER2 expression of the tumors.

scholarly journals Assessment of Role of Platelet Aggregation in Metastatic Breast Cancer Patients

2022 ◽  
Vol 8 (1) ◽  
pp. 81-86
Author(s):  
Ashwini Ramji ◽  
Shanmugan C V
Keyword(s):  
Breast Cancer ◽  
Metastatic Breast Cancer ◽  
Platelet Aggregation ◽  
Cancer Patients ◽  
Metastatic Breast ◽  
Breast Cancer Patients ◽  
Normal Range ◽  
Group I ◽  
Group Ii

Background: To assess role of platelet aggregation in metastatic breast cancer patients.Methods:40 cases (Group I) of metastatic breast cancer patients and equal number of healthy control (Group II) subjects were included. Platelet aggregation studies in vitro using ADP and Thrombin were performed using an optical aggregometer. Detection of platelet aggregation was done by Chrono log series 490 dual and four channel optical aggregometer systems.Results:There were 4 subjects in group I and 12 in group II having ADP <60, 26 subjects in group I and 28 in group II with ADP 61-72 and 10 subjects in group I with ADP >72. Low thrombin <58 was seen in 8 in group II, normal thrombin between 61-72 was seen among 11 in group I and 32 in group II and high thrombin >82 among 29 in group I respectively. Amongst patients with normal platelet count, 14 patients had platelet aggregation with ADP in the normal range and 4 patients had platelet aggregation with ADP in the lower range. In patients with high platelet count, 12 showed aggregation in the normal range, and 10 patients showed aggregation in the higher range which was statistically significant (P< 0.05) (Table III, Graph II).Conclusion: Platelet aggregation has an important part to play in the tumor metastasis of breast cancer patients.

The Effect of Aerobic Exercise Training on Cancer Markers and Quality of Life Women with Breast Cancer Patients: A Randomized Controlled Trial

2021 ◽  
Author(s):  
Deniz Kocamaz ◽  
Nahide AYHAN FIDANCIOGLU ◽  
Ramazan Cihad Yılmaz ◽  
Tülin Düger ◽  
Yavuz Yakut
Keyword(s):  
Breast Cancer ◽  
Quality Of Life ◽  
Aerobic Exercise ◽  
Cancer Patients ◽  
Exercise Group ◽  
Breast Cancer Patients ◽  
Cancer Markers ◽  
Group I ◽  
Group Ii

Abstract Background Exercise interventions in order to improve disease-related symptoms and improve quality of life in cancer patients are an approach that has received a lot of attention in recent years. The aim of our study is to investigate the effect of aerobic exercise on cancer recovery and to determine the change of cancer markers before and after treatment. Methods 70 women between 18–65 years were included in this study during chemotherapy. They were part of two groups; aerobic exercise (Group I) and control (Group II) groups. Their demographic features, quality of life and some cancer markers were evaluated. Assessments were done pre-chemotherapy and post-chemotherapy. In aerobic exercise group third a week aerobic exercises on submaximal level applied. A 12-week exercise program was planned, conducted under the supervision of a physiotherapist. Results As a result of this study, the quality of life in the aerobic exercise group was significantly higher in breast cancer patients receiving chemotherapy treatment (p < 0.05). The three most commonly used cancer markers were measured in the blood of women with breast cancer pre and post treatment. In the pre-treatment period, the mean serum levels of CEA, CEA 15 − 3, and CEA 19 − 9 were similar in Group I and Group II (p > 0.05). In terms of post-treatment evaluation results, the women in Group I had a greater decrease in CEA, CEA 15 − 3, and CEA 19.9 values than the women in Group II (p < 0.05). Conclusion Aerobic exercise has a positive effect on physical function, role function, cognitive state and emotional state, which are subtitles of quality of life. It has been determined that the decrease of cancer markers in blood serum is greater with aerobic exercise.

Prospective Evaluation of Early Cardiac Damage Induced by Epirubicin-Containing Adjuvant Chemotherapy and Locoregional Radiotherapy in Breast Cancer Patients

2001 ◽  
Vol 19 (10) ◽  
pp. 2746-2753 ◽  
Author(s):  
M.T. Meinardi ◽  
D.J. van Veldhuisen ◽  
J.A. Gietema ◽  
W.V. Dolsma ◽  
F. Boomsma ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Adjuvant Chemotherapy ◽  
Diastolic Function ◽  
Cancer Patients ◽  
Natriuretic Peptide ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Breast Cancer Patients ◽  
Ventricular Ejection Fraction ◽  
Group I

PURPOSE: To evaluate prospectively the cardiotoxic effects of epirubicin-containing adjuvant chemotherapy in breast cancer patients. PATIENTS AND METHODS: Patients (median age, 46 years; range, 28 to 55 years) were treated with five cycles of fluorouracil, epirubicin (90 mg/m2), and cyclophosphamide (FEC) (group I, n = 21) or with four cycles of FEC followed by high-dose chemotherapy consisting of cyclophosphamide, thiotepa, and carboplatin (group II, n = 19). Locoregional radiotherapy was applied subsequently. Cardiac evaluation was performed before chemotherapy (T0), 1 month after chemotherapy, 1 month after radiotherapy (T2), and 1 year after start of chemotherapy (T3). Left ventricular ejection fraction (LVEF) was determined by radionuclide ventriculography and diastolic function by echocardiography. Autonomic function was assessed by 24-hour ECG registration for heart rate variability (HRV) analysis. Time-corrected QT (QTc) was assessed and N-terminal atrial natriuretic peptide (NT-ANP) and brain natriuretic peptide (BNP) were measured as biochemical markers of cardiac dysfunction. RESULTS: No patient developed overt congestive heart failure (CHF) and the mean LVEF declined from 0.61 at T0 to 0.54 at T3 (P = .001), resulting in an LVEF below 0.50 (range, 0.42 to 0.49) in 17% of the patients, whereas 28% had a decline of more than 0.10. Plasma NT-ANP levels increased gradually from 237 pmol/L at T0 to 347 pmol/L at T3 (P < .01), whereas plasma BNP levels increased from 2.9 pmol/L to 5.1 pmol/L (P = .04). Mean QTc increased from 406 msec at T0 to 423 msec at T3 (P < .01). No persistent alterations were found in diastolic function and HRV. CONCLUSION: Relatively low doses of epirubicin in adjuvant chemotherapy for breast cancer results in mild subclinical myocardial damage demonstrated by a decline in LVEF, an increase in natriuretic peptide levels, and an increase in QTc, which may indicate a long-term risk of CHF.

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